Form V.19 ELECTORAL ACT [CHAPTER 2:13] ______________ PARLIAMENTARY AND PRESIDENTIAL ELECTIONS: DECLARATION OF SECRECY ______________ I, ................................................................................................................................................ (full names in block letters) being duly appointed as a ................................................................................................................... (here insert “Constituency elections officer”, Deputy Constituency elections officer”, “Assistant Constituency elections officer”, “Presiding Officer”, “Candidate” or “Candidate’s Agent”, as the case may be) do solemnly promise and declare that I will not, at this election of a member of Parliament of Zimbabwe for the constituency of ……………………………………………….., do anything forbidden by sections 86 and 87 of the Electoral Act [Chapter 2:13], which sections I have read. (Signed) ............................................. Address ............................................................................................................................................. Date ....................................................................................... , 20 ......... The above declaration was made and subscribed before me this ……….……………… day of ………………………………., 20…………., by the declarant, after having read sections 86 and 87 of the Electoral Act[Chapter 2:13]. Place ...................................................................................... Date ....................................................................................... , 20 ......... (Signed) ………………………………………. Constituency elections officer or Commissioner of Oaths - 40 -