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C-15, r. 8 - Regulation respecting elections to the board of directors of the Ordre des chimistes du Québec

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SCHEDULE VII
(s. 19)
OATH CERTIFYING THAT A BALLOT PAPER HAS BEEN DAMAGED, SPOILED OR LOST, OR HAS NOT BEEN RECEIVED, OR THAT AN ENTRY THEREON HAS BEEN STRUCK OUT
(date) ______________________________________
I, the undersigned, ______________________________ , member in good standing of the Ordre des chimistes du Québec, swear that I ______________________________ (damaged, spoiled, lost, did not receive or struck out an entry on) my ballot paper for the election to the office of ______________________________ (president or director) of the Ordre des chimistes du Québec and request that another ballot paper be issued to me by the secretary of the Order.
In witness whereof, I have signed at ______________________________ , this __________ day of ______________________________ .
___________________________________________
(signature of member)
Sworn before me (or, as the case may be) Received before me
at ______________________, at ______________________,
this __________ day of this __________ day of
________________________ . ________________________.
(month) (year) (month) (year)
______________________________________________________________________________
Commissioner for oaths for the judicial district of _____________________________________

(signature of secretary)
O.C. 1692-93, Sch. VII.
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