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DUTY
CERTIFICATE
11/20/18 06:02:04 AM
1
GUIDELINES FOR
ISSUE OF
ELECTION
DUTY
CERTIFICATE
POSTAL BALLOT
PO will brief all the Polling Agents that Polling Personnel with
EDC can vote on ONLY on the basis of EDC
Enter the total number of EDC Voters against item No. 13 in the
Presiding Officers Diary.
To
The Returning Officer
02 - South Goa Parliamentary Constituency
Sir,
I intend to cast my vote in person at the ensuing election to the House of the People from the .
but my name is entered at Sr. No. 329 Part No. 06 of the electoral rolls for 40 – Canacona
. . . . .
I request that an Election Duty Certificate in FORM 12B may be issued to enable me to vote at
the Polling Station where I may be on duty on the polling day. It may be sent to me at the
following address:-
…………………………………..
…………………………………..
Yours faithfully
Place: ……………………
Date: ……………………. [ Signature ]
Name in Full
FORM 12B
[ See Rule 20(2) and 35A ]
ELECTION DUTY CERTIFICATE
No.: _________
[ Parliamentary Constituency, his electoral roll number being . 329 Part No.
. . 06 of
.
That by reason of his being on election duty he is unable to vote at the Polling
Station where he is entitled to vote and that he is therefore hereby authorized to
vote at any Polling Station in the said constituency where he may be on duty on the
date of poll.
Place: ……………………
Date: ……………………. [ Signature ]
SEAL Returning Officer