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[See rule 63 (4) ]
Revocation of the appointment for
Counting Agent
Election to the * …………………………….Grama ** /Taluk/Zilla Panchayat from
the * ……………………………..constituency
To:
Returning Officer:
………………………
………………………
I, ……………………………. a candidate ** / the Election Agent ………..… of ………………….who
is a candidate at the above election hereby revoke the appointment
of ……………………….my ** / his counting Agent.
Place :
| Date |
Signature of the Candidate
** /Election Agent
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* Appropriate particulars to be inserted here.
** Strike off the inappropriate alternative.
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