S-4.2, r. 22 - Regulation respecting the procedure for designating 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 VI

(s. 24)

DESIGNATION

NORD-DU-QUÉBEC INSTITUTION

Vote Count Report

Institution(s): ________________________________________________________________________

Designation college: __________________________________________________________________

Polling location: ______________________________________________

In accordance with the polling notice, the vote count took place on ____________________, in _____________________

Envelopes with voter identified: __________

Envelopes containing no vote envelopes: __________

Envelopes containing more than one vote envelope: __________

Vote envelopes counted: __________

Uncounted vote envelopes: __________

Candidates Number of votes

(1) ____________________ ____________________

(2) ____________________ ____________________

(3) ____________________ ____________________

Valid ballots __________

Rejected ballots __________

Total __________

Signed in ____________________, on ____________________

_______________________________

Signature

_______________________________

Name of designation officer

_______________________________

Name(s) of scrutineer(s)

M.O. 2006-013, Sch. VI.