ELECTORAL ACT ____________________________________________________________________________________ 12. Full names ................................................................................................................ (Block letters) National Registration No. .......................................................................................... Signature ……......................................................... .. Date .................................... Signed in the presence of .......................................................................................... (Candidate/Chief Election Agent/Authorized Representative) DECLARATION BY OR ON BEHALF OF CANDIDATE ................................................................................................................................................... (full name of candidate, in block letters) ................................................................................................................................................... (address of candidate, in block letters) Candidate’s telephone No. ......................................................................................................... I certify that: 1. The candidate is qualified for election in terms of subsection (1) of section 28 of the Constitution. 2. Each of the persons nominating the candidate signed this nomination paper in the presence of the candidate or his/her election agent or his/her authorized representative. 3. The candidate accepts the above nomination as a candidate for election to the office of President. Date …………………………… Signature …... ………………���…………………………. Candidate/Candidate’s Chief Election Agent DISTINCTIVE SYMBOL AND PARTY NAME AND ABBREVIATION (This part is to be completed if the candidate wishes a distinctive symbol and/or Party identification to appear on the ballot.) 1. Distinctive Symbol The candidate wishes the following symbol to appear on the ballot paper in conjunction with his name: (Show drawing of symbol here) Short description of symbol: ............................................................................................... 2. Party Identification The candidate will be standing for or be sponsored by the following party: ............................................................................................................................................ ............................................................................................................................................ (full name of party in block letters) 185