E-3.3, r. 17 - Voting Regulation

Schedule Disposition versions

2012-09-01

FORM 50

Election Act

(chapter E-3.3, s. 340)

AUTHORIZATION TO VOTE

   
 _____________________________________             ______________________________
|                                     |           |                              |
|  Electoral Division:                |           |   Polling Subdivision:       |
|_____________________________________|           |______________________________|

 ___
|   |  I attest that the revised list of electors for the said polling
|___|  subdivision of the electoral division contains the following entry:

 ___
|   |  I attest that the following name was the subject of an entry or correction 
|___|  duly accepted by the appropriate board of revisors:

 ___
|   |  I attest that the following elector has left his domicile to ensure his
|___|  safety or the safety of his children and has availed himself of the  
       provisions of section 3 of the Election Act:
_________________________________________________________________________________,
                                      Name                                        
_________________________________________________________________________________,
                               Domiciliary address
_______________________________________ , _______________________________________
                  Sex                                 Date of birth    

Signed at _______________________________________________________________________,
this____________________________________________________________, 20_____________.

                                         ________________________________________
                                                   Returning Officer   

                                                             OR

                                         ________________________________________
                                               Assistance Returning Officer             

Decision 89-03-23, Form 50; Decision 2000-12-20, s. 5; Erratum, 2001, G.O. 2, 1832; Decision 2004-03-31, s. 2.