INDEPENDENT NATIONAL ELECTORAL COMMISSION

Transcription

1 FORM E.C. 4B (v) 2015 INDEPENDENT NATIONAL ELECTORAL COMMISSION NOMINATION FORM FOR MEMBER HOUSE OF REPRESENTATIVES NAME OF CANDIDATE:.. CONSTITUENCY:.. STATE:.

2 Affix passport photograph INDEPENDENT NATIONAL ELECTORAL COMMISSION FORM FOR NOMINATION OF MEMBER HOUSE OF REPRESENTATIVES To: Independent National Electoral Commission,.. Date I,.. of... (Address). (Occupation) hereby state that: 1. I am the candidate to whom this nomination paper relates and willing to stand for election to the House of Representatives as a member representing Federal Constituency of State 2. I am a Nigerian citizen of not less than 30 years of age 3. My voter s registration particulars are as follows: a. Delimitation:.. b. Date of issue:.. 4. My educational qualifications are: 5. I am sponsored by. (Name of Political Party) Signed: Candidate for the House of Representatives 2

3 We, being registered Voters in the above named Constituency, do nominate the above candidate for election into the House of Representatives in... Constituency of.. State. Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of First Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Second Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Third Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Fourth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Fifth Nominator 3

4 Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Sixth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Seventh Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Eighth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Ninth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Tenth Nominator 4

5 Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Eleventh Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twelfth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Thirteenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Fourteenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Fifteenth Nominator 5

6 Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Sixteenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Seventeenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Eighteenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Nineteenth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth Nominator 6

7 Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth First Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth Second Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth Third Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth Fourth Nominator Name:... Address:... Occupation:.. Delimitation: Date of issue:.. Signature of Twentieth Fifth Nominator NB: Note that it is an offence to nominate more than one person for an election to the same office (Section 32 (2) of the Electoral Act, 2010) 7