FORM - IV
[See paragraph 5 (b) of the Schedule]
Application for appointing election agent
I, name of father/spouse member of
(name of the society) contesting for election of members of board of
directors/office bearers do hereby nominate the following person an my election agent/counting agent in the
election (name of the society) to be held on (specify the date).
Name and Signature of the candidate
