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I-8, r. 15 - Regulation respecting elections to the board of directors of the Ordre des infirmières et infirmiers du Québec

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SCHEDULE V
(s. 14)
OATH CERTIFYING THAT A BALLOT PAPER WAS DAMAGED, SPOILED, DEFACED, LOST OR NOT RECEIVED
(Date) _______________________________________
I, the undersigned, ______________________________ member in good standing of the Ordre des infirmières et infirmiers du Québec, swear that:
□ my ballot paper for the election for the office of president of the Ordre des infirmières et infirmiers du Québec has been damaged, spoiled, defaced or lost
□ I did not receive a ballot paper for the election for the office of president of the Ordre des infirmières et infirmiers du Québec and that another ballot paper has been issued to me by the secretary of the Order.
In witness whereof, I have signed at _______________________ , this _________________________ day of __________(month)__________ __________(year)__________
___________________________________________
(Signature of member)
Sworn before me, at __________________________
this ___________ day__________of 20__________
___________________________________________
Commissioner for oaths for the judicial
district of __________________________________
___________________________________________
Signature of secretary
O.C. 1367-92, Sch. V.
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