Election of Councillors to the Corporation
of the City of
.. from the
.a Candidate/*** the Election
. who is a candidate t the above election do
.(Name and address)
as a Polling Agent to attend Polling Station No
for poll at (time)
Signature of Candidate
/ ***Election Agent
I agree to act as Polling Agent.
Signature of the Polling
Declaration of Polling Agent to be signed before the Presiding
I hereby declare that at the above
election, I will not do anything forbidden by section 44 of the
Karnataka Municipal Corporation Act, 1976 which I have read/has
been read over to me.
Signature of Polling Agent
Signed before me
* To be handed over to the Polling Agent for production at the
Polling station or at the place fixed for the poll.
** Appropriate particulars of the election to be inserted.
** Score off the inappropriate alternative
Section 44 of the Karnataka Municipal Corporation Act, 1976
"Maintenance of secrecy of voting - (1) Every Officer, agent
or other person who performs any duty in connection with the recording
or counting of votes at an election under this Act shall maintain
and aid in maintaining, the secrecy of the voting and shall not,
except for some purpose authorized by or under any law, communicate
to any person any information calculated to violate such secrecy.
Any person who contravenes the provision of sub-section(1) shall
be punishable with imprisonment for a term which may extend to
three months or with fine or with both."