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E-3.3, r. 7 - Nomination Regulation
Schedule
Disposition versions
FORM 42
NOMINATION PAPER
FORM 42
NOMINATION PAPER
LE DIRECTEUR GÉNÉRAL DES ÉLECTIONS DU QUÉBEC
Nomination paper
Version française disponible sur demande
Identification of candidate IMPORTANT
* Given name The opposite given name
* Surname and surname will be entered
on the ballet paper
Where applicable, I have appended and affidavit to the effect that my ordinary name and surname are those under which I am commonly known in political, professional and social life.
* Date of birth Year – Month - Day
* Occupation
* Address Number, Street, Municipality, Postal code
Optional Home phone no. Office phone no. E-mail
________________________________________________________________________
Status
* Membership of an authorized party
(Name of the party as authorized)
I am appending hereto a letter from leader of the authorized party who recognizes me as being a candidate of that party
OR
* Whish that the particular “independent” appear on the ballot paper
French
Yes in English
French/English
English/French
No
________________________________________________________________________
Official agent
* Given name
* Surname
* Address Number, Street, Municipality, Postal Code
Optional Home phone no. Office phone no. E-mail
* Signature of the official agent ______________________________________________
______________________________________________________________________________________
Identification of the mandataries
* Given name
* Surname
* Address Number, Street, Municipality, Postal Code
Optional Home phone no. Office phone no. E-mail
* Signature and initials of the mandatary: ____________________________________________________
______________________________________________________________________________________
* Mandatory information
Declaration of the candidate
* I have appended hereto
my birth certificate
OR one of the following identification documents
my Québec health-insurance card
my Certificate of Canadian citizenship
my Québec driver’s licence
my Canadian passport
a copy of the Order changing my name
AND
a photograph showing a full face view of the from the shoulders, bareheaded, against a plain light background and printed on single thickness paper measuring approximately 13 cm x 13 cm, in according with section 6 of the Nomination Regulation, and signed on the back by 2 electors from the electoral division who know me and attest to my identity.
* I, __________________________________________________, submit my candidacy in the electoral division of _______________________________________________________________________________________,
and state that:
1. I am a qualified elector within the meaning of section 1 of the Election Act;
2. I have not been disqualified within the meaning of section 235 of the Election Act.
* In witness whereof, I have signed
at_____________________________________, on _______________________20____.
__________________________________________
Candidate’s signature
______________________________________________________________________________________
* Mandatory information
Supporting signatures
We, the undersigned, electors entered on the list of electors of the electoral division of ________________,
hereby support the candidacy of:
Given name Surname
for the election of a Member of the National Assembly for said electoral division.
______________________________________________________________________________________
The elector who supports a nomination paper must be entered on the list of electors for the electoral division for which the signature is collected.
Legal provisions
According to section 245 of the Election Act, the returning officer shall verify if the persons supporting the candidacy are indeed entered on the list of electors for the electoral division.
Penalties (s. 553 (2) (3) of the Election Act) Every person who supports a nomination paper, when he is not an elector whose name is entered on the list of electors for the electoral division for which the nomination paper is filed and every person who uses the signature of others as support on a nomination paper is liable to:
1° A fine of $500 to $10,000 for a first offence;
2° A fine of $3,000 to $30,000 for every subsequent offence within 5 years.
WRITE LEGIBLY AND IN BLOCK LETTERS YOUR SURNAME, GIVEN NAME AND ADDRESS AS THEY ARE ENTERED ON THE LIST OF ELECTORS
Space reserved for Verification
No. (1 to70)
Surname (at birth)
Given name
Address (of domicile)
Municipality
Signature
Initials of the person who collects the signatures
______________________________________________________________________________________
Oath of the person who collects the supporting signatures
Candidate
I, (Given name) (Surname)
state under oath that the ________ persons whose names appear opposite my initials on the nomination paper affixed their signature in my presence, that I know them and that to my knowledge they are electors of the electoral division.
_________________________________________
Signature of the candidate
Stated under oath before me, at ____________________________________________________________,
on ______________________20, _____________________________________
Signature of the returning officer
______________________________________________________________________________________
Mandatary
I, (Given name) (Surname)
state under oath that the ________ persons whose names appear opposite my initials on the nomination paper affixed their signature in my presence, that I know them and that to my knowledge they are electors of the electoral division.
_________________________________________
Signature of the mandatary
Stated under oath before me, at ____________________________________________________________,
on ______________________20, _____________________________________
Signature of the returning officer
______________________________________________________________________________________
Receipt
I, _______________________________________, returning officer, have received this nomination paper. All of the required documents are appended hereto. Subject to the verification of the entry on the list of electors of the electors supporting this nomination paper, in all appearances it meets the requirements of the Election Act.
On ______________________20 ___.
_________________________________________________________
Signature of the returning officer
______________________________________________________________________________________
Notice of conformity
I certify that at least one hundred electors supporting this nomination paper are indeed entered on the list of electors for the electoral division and that this nomination paper meets the requirements of the Election Act.
On ______________________20 ___, at__________ o’clock.
________________________________________________
Signature of the returning officer
Nomination paper
Version française disponible sur demande
Identification of candidate IMPORTANT
* Given name The opposite given name
* Surname and surname will be entered
on the ballet paper
Where applicable, I have appended and affidavit to the effect that my ordinary name and surname are those under which I am commonly known in political, professional and social life.
* Date of birth Year – Month - Day
* Occupation
* Address Number, Street, Municipality, Postal code
Optional Home phone no. Office phone no. E-mail
________________________________________________________________________
Status
* Membership of an authorized party
(Name of the party as authorized)
I am appending hereto a letter from leader of the authorized party who recognizes me as being a candidate of that party
OR
* Whish that the particular “independent” appear on the ballot paper
French
Yes in English
French/English
English/French
No
________________________________________________________________________
Official agent
* Given name
* Surname
* Address Number, Street, Municipality, Postal Code
Optional Home phone no. Office phone no. E-mail
* Signature of the official agent ______________________________________________
______________________________________________________________________________________
Identification of the mandataries
* Given name
* Surname
* Address Number, Street, Municipality, Postal Code
Optional Home phone no. Office phone no. E-mail
* Signature and initials of the mandatary: ____________________________________________________
______________________________________________________________________________________
* Mandatory information
Declaration of the candidate
* I have appended hereto
my birth certificate
OR one of the following identification documents
my Québec health-insurance card
my Certificate of Canadian citizenship
my Québec driver’s licence
my Canadian passport
a copy of the Order changing my name
AND
a photograph showing a full face view of the from the shoulders, bareheaded, against a plain light background and printed on single thickness paper measuring approximately 13 cm x 13 cm, in according with section 6 of the Nomination Regulation, and signed on the back by 2 electors from the electoral division who know me and attest to my identity.
* I, __________________________________________________, submit my candidacy in the electoral division of _______________________________________________________________________________________,
and state that:
1. I am a qualified elector within the meaning of section 1 of the Election Act;
2. I have not been disqualified within the meaning of section 235 of the Election Act.
* In witness whereof, I have signed
at_____________________________________, on _______________________20____.
__________________________________________
Candidate’s signature
______________________________________________________________________________________
* Mandatory information
Supporting signatures
We, the undersigned, electors entered on the list of electors of the electoral division of ________________,
hereby support the candidacy of:
Given name Surname
for the election of a Member of the National Assembly for said electoral division.
______________________________________________________________________________________
The elector who supports a nomination paper must be entered on the list of electors for the electoral division for which the signature is collected.
Legal provisions
According to section 245 of the Election Act, the returning officer shall verify if the persons supporting the candidacy are indeed entered on the list of electors for the electoral division.
Penalties (s. 553 (2) (3) of the Election Act) Every person who supports a nomination paper, when he is not an elector whose name is entered on the list of electors for the electoral division for which the nomination paper is filed and every person who uses the signature of others as support on a nomination paper is liable to:
1° A fine of $500 to $10,000 for a first offence;
2° A fine of $3,000 to $30,000 for every subsequent offence within 5 years.
WRITE LEGIBLY AND IN BLOCK LETTERS YOUR SURNAME, GIVEN NAME AND ADDRESS AS THEY ARE ENTERED ON THE LIST OF ELECTORS
Space reserved for Verification
No. (1 to70)
Surname (at birth)
Given name
Address (of domicile)
Municipality
Signature
Initials of the person who collects the signatures
______________________________________________________________________________________
Oath of the person who collects the supporting signatures
Candidate
I, (Given name) (Surname)
state under oath that the ________ persons whose names appear opposite my initials on the nomination paper affixed their signature in my presence, that I know them and that to my knowledge they are electors of the electoral division.
_________________________________________
Signature of the candidate
Stated under oath before me, at ____________________________________________________________,
on ______________________20, _____________________________________
Signature of the returning officer
______________________________________________________________________________________
Mandatary
I, (Given name) (Surname)
state under oath that the ________ persons whose names appear opposite my initials on the nomination paper affixed their signature in my presence, that I know them and that to my knowledge they are electors of the electoral division.
_________________________________________
Signature of the mandatary
Stated under oath before me, at ____________________________________________________________,
on ______________________20, _____________________________________
Signature of the returning officer
______________________________________________________________________________________
Receipt
I, _______________________________________, returning officer, have received this nomination paper. All of the required documents are appended hereto. Subject to the verification of the entry on the list of electors of the electors supporting this nomination paper, in all appearances it meets the requirements of the Election Act.
On ______________________20 ___.
_________________________________________________________
Signature of the returning officer
______________________________________________________________________________________
Notice of conformity
I certify that at least one hundred electors supporting this nomination paper are indeed entered on the list of electors for the electoral division and that this nomination paper meets the requirements of the Election Act.
On ______________________20 ___, at__________ o’clock.
________________________________________________
Signature of the returning officer
