FORM 9

[See Rule 22(2) ]

Revocation of Appointment of Election Agent


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


To:
The Returning Officer,
..
..


I, .... a candidate at the above election hereby revoke the appointment of . my Election Agent.


Place :  
Date :
Signature of the Candidate


* Appropriate particulars of the election to be inserted here