Form 'M-4' Form of Nomination Paper
[See Rule 56M (2)]
Download the Word or PDF Format of form M-4 from here.
Election to the .......................... Co-operative Society Ltd.....................
Tahsil ... ............................ , District ................................(To be filled by the Proposer)
I hereby nominate Shri/Smt ................................................ as a candidate
for election from the .......................................................... constituency.
1. Name of the constituency
2. Name of candidate (father's/husband's name)
3. Age
4. Full postal address of the candidate
5. Name of the constituency: -
(i) In a constituency having a reserved seat, state
the particulars of the caste or tribe or the weaker
section to which the candidate belongs.
(ii) The name of the constituency in which the name
of the candidate Is entered as a voter in the list
of voters.
(iii) Serial Number of the candidate in the list of
voters of the constituency aforementioned in
which his name is entered as a voter.
(iv) Name of the proposer
(v) Serial Number of the proposer in the list of
voters of the constituency.
Signature of the proposer
Name of the seconder Shri/Smt, .......................................... serial number
of the seconder in the list of voters of the constituency ....................................
Signature of the proposer
Declaration by candidate
I hereby signify my willingness to serve as a member of the committee of the
society, if I am elected.
Date:
Signature of the candidate
Declaration to be made by the Scheduled Caste, Scheduled Tribe or weaker section candidate
I hereby declare that I am a member of the ...........................................
Caste/Tribewhich is a Scheduled Caste/Tribe in relation to the State of Maharashtra
or a weaker section, within the meaning of Section 73-B of the said Act
Signature of the candidate
Declaration as to choice of symbol
I do hereby declare that the symbols which I have chosen for my election are
shown below in the order of my preference :-
(1) ....................................
(2) ....................................
(3) ....................................
Serial number of nomination papaer ................................................ This
nomination was delivered to me at my office at...................................... (hour)
on .................................................................................................. (date)
by the Candidate/Proposer of the Candidate.
Date:
Signature of Returning Officer
Decision of Returning Officer accepting or rejecting the nomination paper
I have examined this nomination paper in accordance with Rule 58-A(27) of the
Maharashtra Specified Co-operative Societies Election to Committee's Rules and
decide as follows :-
date:
Signature of Returning Officer
Receipt for Nomination paper and notice of scrutiny
(To be handed over to the persons presenting the nomination paper)
Serial number of Nomination paper .....................................The nomination
paper of .......................................................................... a candidate for
election from the .............................................................. constituency of
...................................................................................... Co-operative
Society Ltd., was delivered to me at my office at ................... (hour) on...
...................................................................................... (date) by...........
Candidate/Proposer of candidate.
All nomination papers will be taken up for scrutiny at........................ (hour)
on ...................... (date) at ......................
Place:
date:
Signature of Returning Officer