E-3.2 - Election Act

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SCHEDULE G

STATEMENT OF POLL

Electoral division of .........................................

Polling subdivision No. .....
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Number of ballot papers received from the . .
returning officer ............................. . . ....
. .
Number of ballot papers cast for ................ . ... .
(Name of the first candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the second candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the third candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the fourth candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the fifth candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the sixth candidate) . .
. .
Number of ballot papers cast for ................ . ... .
(Name of the seventh candidate) . .
. .
Number of ballot papers spoiled (not placed in . .
box) .......................................... . ... .
. .
Number of ballot papers rejected in counting the . .
ballots ....................................... . ... .
. .
Number of ballot papers not used ................ . ... .
.-----.-----
. .
Totals .......................................... . ... . ...
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Given under my hand, at ....................................,
this ................................................... 19....

.............................
Deputy Returning Officer
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1984, c. 51, Schedule G.