ELECTORAL ACT ____________________________________________________________________________________ We, the undersigned voters registered on voters rolls for constituencies within the provinces listed hereunder, hereby nominate: .................................................................................................... I/D No. ............................. (full names in block letters) Of……………… ........................................................................................................................ (full address in block letters) as a candidate for election to the office of President. A. HARARE: 1. Full names ................................................................................................................ (Block letters) National Registration No. ................ of (Residential Address): .................................................................................................................................. Signature……................................................... Date .............................................. Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) 2. Full names ................................................................................................................ (Block letters) National Registration No. .......................................................................................... Signature ……......................................................... .. Date .................................... Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) 3. Full names ................................................................................................................ (Block letters) National Registration No. .......................................................................................... Signature ……......................................................... .. Date .................................... Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) 4. Full names ................................................................................................................ (Block letters) National Registration No. .......................................................................................... Signature ……......................................................... .. Date .................................... Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) 5. Full names ................................................................................................................ (Block letters) National Registration No. .......................................................................................... Signature ……......................................................... .. Date .................................... Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) 165