FORM 13

[See rule 25 (2) ]

Revocation of Appointment of Counting Agent


Election to the Councillors to the City Municipal Council/Town Municipal Council/Town Panchayat of the City/Town of . from ..*ward.


To:

The Returning Officer,

.

.


I, ... a candidate / ** the Election Agent of .a candidate at the election hereby revoke the appointment of . my / ** his/her Counting Agent.

Place :
Date:
Signature of person revoking


* Appropriate particulars of the election to be inserted.
** Score off the inappropriate alternative.