S-4.2, r. 12 - Regulation respecting the election by the public of certain members of the board of directors of the public institution referred to in Part IV.2 of the Act respecting health services and social services

Schedule Disposition versions

2012-09-01

SCHEDULE VIII

(s. 32)

ELECTION BY THE PUBLIC

NORD-DU-QUÉBEC INSTITUTION

Vote Count Report

Institution: __________________________________________________________________________

Subregion number: __________

Polling location: ___________________

Polling date: ______________________

Polling period: ____________________

Candidates Number of votes

(1) ____________________ _______________

(2) ____________________ _______________

(3) ____________________ _______________

(4) ____________________ _______________ Valid ballot papers __________

(5) ____________________ _______________ Rejected ballot papers __________

(6) ____________________ _______________ Total __________

Signed in _____________________________, on _____________________________

_____________________________

Signature

__________________________________________________

Name of the returning officer or deputy returning officer

M.O. 2006-014, Sch. VIII.