All orders, directions, etc., issued by the Government, State Election Commission or District Election Officer, for the preparation of electoral rolls and for the conduct of elections under these Rules, shall unless repugnant to these Rules, be deemed to have been issued or made under these Rules.
J.T ACHARYULU SPECIAL COMMISSIONER AND SECRETARY TO GOVERNMENT
1. Published in Tamil Nadu Government Gazette (Extraordinary), Part III – Section 1(a) Issue No.411, dated 7th August 1995.
2 Substituted by G.O.Ms.No.175, Rural Development (Panchayat Elections) dated 28th August
1996.
3. Clause (xix) “Other elected member” means-(a) in the case of a District Panchayat, the Chairman of a Panchayat Union Council elected to represent in the District Panchayat under sub-section (2) of Section 25 of the Act; and (b) in the case of a Panchayat Union Council, the President of a Village Panchayat, elected to represent in the Panchayat Union Council under sub-section (2) of Section 17 of the Act” was omitted by G.O.Ms.No. 282, Rural Development (C4), dated 30th October 2000
4. Substituted by ibid.
5. Inserted by G.O.Ms.No. 299, Rural Development (4), dated 13th November, 2000.
6. The words of “offices of members” substituted by G.O. M.s.No.175, Rural Development (Panchayat Elections) dated 28th August, 1996.
7. The expression "other elected members to the Panchayat Union Councils and District Panchayats” is omitted by G.O.Ms.No. 282, Rural Development (C4), dated 30th October,
2000.
8. Substituted by G.O.Ms.No.299, Rural Development (C4), dated 13th November 2000.
9. The words “and other Statutory Committees” was omitted by G.O.Ms.No. 183, Rural Development, dated 31st August, 1998.
10. Rule 6-A inserted by G.O.Ms.No. 86, Rural Development and Panchayat Raj (C4), dated 27th July 2006.
11. Substituted for the words “Divisional Development Officer” by G.O.Ms.No.282, Rural development (C4) dated 30th October 2000.
64
12. Substituted by G.O.Ms.No. 151, Rural Development (C1), dated 2nd June, 2001.
13. Substituted by G.O.Ms.No. 282, Rural Development (C4) dated 30th October, 2000.
14. The words “backward classes” omitted by G.O.Ms.No. 163, Rural development, dated 7th August 1996.
Note: See 2002 TNLJ (2), Page 312 – Rejection of Nomination Paper and Parties to the election Petition.
15. Added by G.O.Ms.No. 175, Rural Development, (Panchayat Elections) dated 28th August,
1996.
16. The words “President of Village Panchayats” were omitted by G.O.Ms.No. 282, Rural Development (C4), dated 30th October, 2000.
17. Inserted by G.O. Ms.No.151, Rural Development (C1), dated 2nd June 2001.
18. The words “President of Village Panchayats” omitted by G.O.Ms.No.175, Rural Development (Panchayat Elections),dated 28th August, 1996.
19. Inserted by ibid.
20. Inserted by G.O.Ms.No. 241, Rural Development (Panchayat Elections), dated 24th September 2001.
21. Substituted by G.O.Ms.No. 235, Rural Development (Panchayat Elections), dated 24th October 1996.
22. Substituted for the words “thirty days’ by G.O.Ms.No. 168, Rural Development (C4), dated 1st November 2004.
23. Added by G.O.Ms.No. 136, Rural Development (C4, dated 1st September 2004.
24. Added by G.O.Ms.No. 44, Rural Development (C1), dated 13th March 1998.
25. Renumbered by G.O.Ms.No. 213, Rural Development (PE), dated 21st August 2001.
26. Inserted by G.O.Ms.No. 48, Rural Development (C4), dated 29th February, 2000.
27. Omitted by G.O.Ms.No. 282, Rural Development (C4), dated 30th October 2000.
28. Inserted by G.O.Ms.No. 179, Rural Development (C4), dated 30th August, 1999.
29. Sub-rule (1) of Rules 121 substituted by G.O.Ms.No. 90, Rural Development and Panchayat Raj (C4), dated 2nd August 2006.
30. Substituted for the expression “fifteen days’ by the G.O.Ms.No. 116, Rural Development (C4), dated 22nd July 2004.
* Now, Secretary of the District Panchayat – vide Tamil Nadu Act 28 of 1998.
65 FORM 1 NOTICE OF PUBICATION OF ELECTORAL ROLL [See Rule 20 (1)] Notice is hereby given that Panchayat Electoral Roll has been prepared in accordance with the Tamil Nadu Panchayats (Elections) Rules, 1995 by adopting the existing entries in the relevant part of the electoral roll of the Tamil Nadu Legislative Assembly___________________________________ Constituency. A copy thereof relating to the __________________________ Ward of the ___________________ Panchayat Village /Panchayat Union/District Panchayat has been published for inspection at my office and at the offices of the Panchayat Village, Panchayat Union and District Panchayat.
Any person who wishes to lodge any claim for including his/her name in the roll or any objection to the inclusion of a name or any objection to the particulars in any entry in the said roll, shall first get such claim or objection settled with reference to the corresponding entry in the Assembly Roll by lodging suitable claim or objection under the provisions of the Representation of the People Act, 1950 and the Registration of Electors Rules, 1960 before the Electoral Registration Officer of the said Assembly Constituency.
All orders of inclusion, deletion or corrections issued on the basis of these claims and objects by the Assembly Electoral Registration Officer till the last date fixed for making nomination for election in the Wards of the Panchayat will be duly incorporated in the Panchayat Electoral Rolls.
Panchayat Electoral Registration Officer, ________________________ Panchayat.
66 FORM 2A NOTICE OF ELECTION [See Rule 25 (1) ] ELECTION OF MEMBERS OF ________ PANCHAYAT UNION COUNCIL/DISTRICT PANCHAYAT.
Notice is hereby given that— 1 (a) Elections are to be held to elect members of Ward/Territorial Wards of ___________ District Panchayat/Panchayat Union;
(b) The number of members to be elected from each Ward/Territorial Ward and those among them which are reserved under Sections 20/32 of the Tamil Nadu Panchayats Act, 1994 for Scheduled Castes, Scheduled Tribes 1[***] or for Women are given below:- RESERVED for S.C. for S.T. 1[***] For Women belonging to Ward or Territorial Ward Member Unreserved for S.C. for S.T. 1[***] Open TOTAL TOTAL 67 Nomination papers may be delivered by a Candidate or his Proposer to the Returning Officer/Assistant Returning Officer at _______________ between 11.00 a.m. and 3.00 p.m. on any day other than a public holiday from ___________ to _______________;
(2) Forms of nomination papers will be available in the office of the District Panchayat and in the office of the Panchayat Union from this date on all working days;
(3) The nomination papers will be taken up for scrutiny at 11.00 a.m. on ________________________ at _______________.
(4) Notice of withdrawal of Candidature may be delivered by a Candidate or his Proposer who has been specifically authorised in this behalf in writing by the Candidate to the Returning Officer/Assistant Returning Officer upto 3.00 p.m. on ________;
(5) In the event of the election being contested, poll will be taken on _______________ between the hours of _________a.m. and _________________ p.m. at the polling stations notified for this purpose;
(6) The counting of votes shall commence at ________ a.m. on _____________.
(7) The election shall be completed before ______________________________.
(8) The meeting of the newly elected Ward Members shall be held on _____________________ at __________________ for the election of the Chairman and/or the Vice Chairman of the Panchayat Union Council/District Panchayat.
Returning Officer.
Place: _____________________________District Panchayat.
Date: ________________________ Panchayat Union Council.
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
68 FORM 2B NOTICE OF ELECTION [See Rule 25 (2) ] ELECTION OF THE PRESIDENT AND MEMBER OR MEMBERS OF WARDS OF _________________ VILLAGE PANCHAYAT.
Notice is hereby given that— 1 (a) Elections are to be held to elect a President and Member or Members of Wards of ___________ Village Panchayat;
(b) The office of the President of this Village Panchayat is not reserved for any category is reserved under Section 57 of the Tamil Nadu Panchayats Act, 1994, for persons belonging to Scheduled Castes/Scheduled Tribes 1[***] or Women;
(c) The number of Members of the Panchayat to be elected from each Ward and those among them which are reserved under Sections 11 of the aforesaid Act, 1994 for persons belonging to Scheduled Castes, Scheduled Tribes 1[***] or Women are given below:- RESERVED for S.C. for S.T. 1[***] For Women belonging to Office Total number of seats for S.C. for S.T. 1[***] Open Unreserved President Member-Ward 1 Ward 2 TOTAL 69
(2) Nomination papers may be delivered by a Candidate or his Proposer to the Returning Officer/Assistant Returning Officer at _______________ between 11.00 a.m. and 3.00 p.m. on any day other than a public holiday from ___________ to _______________;
(3) Forms of nomination papers will be available in the office of the District Panchayat and in the office of the Panchayat Union from this date on all working days and at the office of the Assistant Returning Officer;
(4) The nomination papers will be taken up for scrutiny at 11.00 a.m. on ________________________ at _______________.
(5) Notice of withdrawal of Candidature may be delivered by a Candidate or his Proposer who has been specifically authorised in this behalf in writing by the Candidate to the Returning Officer/Assistant Returning Officer upto 3.00 p.m. on ________;
(6) In the event of the election being contested, poll will be taken on _______________ between _________a.m. and ____________ p.m. at the polling stations notified for this purpose;
(7) The counting of votes shall commence at ________ a.m. on _____________.
(8) The election shall be completed before ______________________________.
(9) The meeting of the newly elected Ward Members shall be held on _____________________ at the office of the ____________________________ Village Panchayat for the election of the Vice President.
Returning Officer.
Place: _____________________________Village Panchayat.
Date: ________________________ Panchayat Union Council.
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
70 FORM 3 NOMINATION PAPER [See Rule 26 (1), (2) and 30] Member to Ward No._________of the _______________________ Village Panchayat/Panchayat Union Council/District Panchayat Election of _____________________________________________________________________________________________ President to the ____________________________________________________ Village Panchayat.
(TO BE FILLED IN BY THE PROPOSER) I hereby nominate Thiru./Tmt./Selvi.______________________________________ as a Candidate for the election as a member from Ward No.______________________ of the ________________________________________ Village Panchayat/ Panchayat Union Council/District Panchayat/President of ___________________________________________ Village Panchayat.
His/Her name is entered at Serial No. in Par No.______________________________ of the electoral roll for Ward No._________________ of ______________________ Village Panchayat comprised in _____________________________ Panchayat Union.
Place:
Date: Signature of the Proposer.
(TO BE FILLED BY THE CANDIDATE) I, the above mentioned Candidate assent to this nomination and hereby declare –
(a) that I have completed ___________ years of age;
(b) ** that the symbols I have chosen are in the following order of preference:-
(i)______________________________ (ii) _________________________ (iii) ______________________
(c) that I am aware of the fact that under Rule 30 of the Tamil Nadu Panchayats (Elections) Rules, 1995. I am prohibited from contesting more than one seat as below and further that nomination filed in violation of sub-rule (1) of the above mentioned rule shall be rejected by the Returning Officer:- 71
(i) No member of a Village Panchayat or no person who stands for election as a member of a Village Panchayat shall be eligible to stand for election as a President of a Village Panchayat, or member of a Panchayat Union Council or a member of a District Panchayat.
(ii) No member of a Panchayat Union Council or no person who stands for election as a member of a Panchayat Union Council shall be eligible to stand for election as a member of a Village Panchayat, or President of a Village Panchayat, or member of District Panchayat.
(iii) No member of a District Panchayat or no person who stands for election as a member of a District Panchayat shall be eligible to stand for election as a member of a Village Panchayat or President of a Village Panchayat or member of a Panchayat Union Council.
(iv) No President or no person who stands for election as a President shall be eligible to stand for election as a member of a Village Panchayat, or member of a Panchayat Union Council or a member of District Panchayat.
(v) Under Section 10 of the Tamil Nadu Panchayats Act, 1994, no person shall be eligible to stand for election as a member of a Village Panchayat, or member of a Panchayat Union Council or a member of a District Panchayat.
(d) $ that I am a member of the __________ Caste/Tribe which is Scheduled Caste/Tribe 1[***] of the State of the Tamil Nadu in relation to ____________________________ (area).
** [(e) that I am not employed as Village Administrative Officer or village servant or an officer or servant of the State or Central Government or of a Village Panchayat, Panchayat Union Council, District Panchayat, Municipal Council or Municipal Corporation or of any Industrial Township or of Cantonment or of any body Corporate, owned or controlled by the State or Central Government.]
Place: Signature of the Candidate.
Date:
Note.- ** Item (b) need not be filled in by Candidates for election of member of a Village Panchayat.
$ Item (d) needs to be made only by SC/ST 1[***] candidate.
* Item (e) added by G.O.Ms.No.164, Rural Development(C4), dated 27th October 2004.
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
72 (TO BE FILLED IN BY THE RETURNING OFFICER) Serial number of nomination paper:
The nomination was delivered to me at my office at ______________________(hour) on ________________________ (date) by the Candidate/Proposer.
Place:
Date: Returning Officer.
Receipt for nomination paper and notice of scrutiny (To be handed over to the person presenting the nomination paper) Serial number of nomination paper:
The nomination paper of ________________________________ a Candidate for election as President/Member from Ward No.________________________ of the Village Panchayat/Panchayat Union/District Panchayat, was delivered to me at my office at _____________________ (hours) on ___________________ (date) by the Candidate/Proposer.
All nomination papers will be taken up for scrutiny at 11.00 a.m. on ____________________(date) at ______________________ (place).
Place:
Date: Returning Officer/Assistant Returning Officer.
73 FORM 4 NOTICE OF NOMINATION [See Rule 28 (2)] Election of Member/Members to Ward No.__________________ of the _______________________ Village Panchayat / Panchayat Union council / District Panchayat.
Election of President to the Village Panchayat Serial Number of Nomination Paper Name of Candidate Name of Father / Husband Age of Candidate Address Sex Caste/Tribe (in case of S.C/S.T.
1[***] Candidates) Electoral roll number of the Candidate Name of the Proposer Electoral roll number of the Proposer
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Place:
Date: Returning Officer
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
74 FORM 5 LIST OF NOMINATIONS RECEIVED 1 [See Rules 28(3), (4) and 29 (1)] ____________________________________ Village Panchayat / Panchayat Union Council/ District Panchayat.
List of nomination received for election of Member / Members to Ward No. _________________ of _______________________ Village Panchayat / Panchayat Union Council / District Panchayat:
President to________________________________________________________________________________Village Panchayat Serial Number Name of Candidate Father’s/Husband’s name Community (Scheduled Caste/ Scheduled Tribe 2(***) or not) Sex Address
(1) (2) (3) (4) (5) (6) NOTE: The nomination papers will be taken up for scrutiny at 11.00 a.m. on _________________at ______________(place).
Returning Officer / Assistant Returning Officer.
1. Substituted by G.O.Ms.No.175, Rural Development (Panchayat Elections) Dept., dated 28th August 1996.
2. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
75 FORM 6 LIST OF VALIDLY NOMINATED CANDIDATES 1 [See Rules 28 (3), (4) and 29 (9)] ____________________________Village Panchayat / Panchayat Union Council / District Panchayat.
List of nominations received for election of Member / Members of Ward No.________________ of ________________Village Panchayat / Panchayat Union Council / District Panchayat, President of ______________________ Village Panchayat.
Serial Number Name of Candidate Father’s/Husband’s name Community (Scheduled Caste/ Scheduled Tribe 2(***) or not) Sex Address
(1) (2) (3) (4) (5) (6) Returning Officer / Assistant Returning Officer.
1. Substituted by G.O.Ms.No.175, Rural Development (Panchayat Elections) Dept., dated 28th August 1996.
2. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
76 FORM 7 NOTICE OF WITHDRAWAL [See Rule 30] Election of Member / Members to Ward No.____________________ of __________________________ Village Panchayat/Panchayat Union council / District Panchayat ____________________________________________________ Election of President to ________________________________________________________________Village Panchayat To The Returning Officer, I, ________________________________________________, a Candidate nominated at the above election, do hereby give notice that I withdraw my Candidature.
Place : ________________________ Date : ________________________ Signature of Candidate.
The notice was delivered to me at my office at ______________________(hour) on_______________(date)___________ by _____________________________________ the ____________________________________ Place :
Date : Returning Officer / Assistant Returning Officer.
77 RECEIPT FOR NOTICE OF WITHDRAWAL (To be handed over to the person delivering the notice) The notice of withdrawal of candidature by __________________________________, a Candidate at the election of Member / Members to Ward number ___________________of ____________________________Village Panchayat / Panchayat Union Council / District Panchayat / election of President to ______________________________ Village Panchayat was delivered to me by the * ______________________________ at my office at ____________________________________(hour) on __________________________ (date).
Returning Officer / Assistant Returning Officer.
Note: * Here insert one of the following alternatives as may be appropriate :-
(1) Candidate.
(2) Candidate’s Proposer who has been authorised in writing by the Candidate to deliver it.
78 FORM 8 LIST SHOWING NOTICES OF WITHDRAWAL OF CANDIDATURE [See Rule 30] Election of Member/President ______________________________Village Panchayat/Panchayat Union Council/District Panchayat.
Notice is hereby given that the following Candidate / Candidates at the above election has/have withdrawn his/their Candidature.
Name of the Candidate Address of Candidate Remarks
(1) (2) (3) Place :
Date : Returning Officer / Assistant Returning Officer.
79 FORM 9 LIST OF CONTESTING CANDIDATES [See Rules 31, 32,(1)(a), 2(a), 3(a) 4(a), 4(b), 4(c), 35(4), 41(4)(a) and 49(1)] List of contesting Candidates for election of Member / Members to Ward N0.________of______Village Panchayat/Panchayat Union Council/District Panchayat. President ____________________________________to the Village Panchayat.
Serial Number Name of the candidate Sex Whether the Candidate belongs to Scheduled Caste, Scheduled Tribe 1[***] or not Address of Candidate Distinctive symbol assigned to the Candidate
(1) (2) (3) (4) (5) (6) NOTE.- The poll will be taken on ________ between ________a.m. and ______p.m at the polling stations noticed for the purpose.
Place :
Date : Returning Officer / Assistant Returning Officer.
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
80 FORM 10 APPOINTMENT OF ELECTION AGENT [See rule 38] Election of Member / Members to Ward No. ________of_________ Village Panchayat/Panchayat Union Council/District Panchayat.
President to__________________Village Panchayat.
To The Returning Officer, I, _________________________________of __________________________, a Candidate at the above election do hereby appoint Thiru / Tmt / Selvi_______________________ of______________ as my election Agent from this day at the above election.
Place :
Date: Signature of Candidate.
I accept the above appointment.
Place: Signature of Election Agent.
Date:
81 FORM 11 APPOINTMENT OF POLLING AGENT [See Rule 38] Election of Member / Members to Ward No. ________ of ________Village Panchayat/Panchayat Union Council/District Panchayat.
President to _____________ Village Panchayat.
I, _______________________ a Candidate / Election Agent of___________________________who is candidate in the above election to hereby appoint Thiru___________of____________as Polling Agent to attend the polling station No.____________ at _____________________.
His recent photograph, duly attested be me is pasted below:- Place:
Date: Signature of Candidate or Election Agent..
I accept the above appointment.
Place :
Date: Signature of Polling Agent.
82 DECLARATION OF POLLING AGENT TO BE SIGNED BEFORE THE PRESIDING OFFICER I hereby declare that at the above election I will not do anything forbidden by Section 58 of the Tamil Nadu Panchayats Act, 1994 which I have read / has been read over to me.
Place:
Date : Signature of Polling Agent.
Signed before me.
Date :
Place : Signature of Presiding Officer.
(TO BE HANDED OVER TO THE POLLING AGENT FOR PRODUCTION AT THE POLLING STATION) Section 58 of the Tamil Nadu Panchayat Act, 1994.
“Every Officer, Clerk, Agent or other person performing any duty in connection with the recording or counting of votes at an election who, except for some purpose authorised by law, communicate to any person any information showing directly or indirectly for which Candidate any voter has voted, and every person, who by improper means procures any such information, shall be punished with imprisonment which may extend to six months or with fine, or with both”.
83 FORM 12 [See Rule 42 (6)]
PART – I DECLARATION BY THE PRESIDING OFFICER BEFORE THE COMMENCEMENT OF POLL Election of Member/Members to Ward No._________ of ________ Village Panchayat/Panchayat Union Council/District Panchayat.
President to________________ Village Panchayat.
Number and Name of the Polling Station :____________________________________________________________ Date of Poll : ______________________________ I hereby declare –
(1) that I have demonstrated to the Polling Agents and other persons present that the ballot boxes to be used for the poll are empty :
(2) that on the paper seal used for securing the ballot box, I have affixed my own signature and obtained thereon, the signatures of such of the Polling Agents who are present and desirous of affixing the same.
(3) that I have demonstrated to the Polling Agents and others present that the marked copy of the electoral roll/rolls to be used during the poll does / do not contain any marks other than those used for issuing election duty certificates, and
(4) that I have allowed the Polling Agents to note the first and the last of the serial numbers of the ballot papers and also the numbers on the paper seals which will be used at the polling station.
Signature of Presiding Officer.
84 Signature of Polling Agents –
1._______________________________________(of Candidate_________________________________)
2._______________________________________(of Candidate_________________________________)
3._______________________________________(of Candidate_________________________________)
4._______________________________________(of Candidate_________________________________)
5._______________________________________(of Candidate_________________________________)
6._______________________________________(of Candidate_________________________________)
7._______________________________________(of Candidate_________________________________)
8._______________________________________(of Candidate_________________________________)
9.________________________________________( of Candidate_______________________________) The following Agents declined to affix their signatures to this declaration :-
1._______________________________________(of Candidate_________________________________)
2._______________________________________(of Candidate_________________________________)
3._______________________________________(of Candidate_________________________________)
4._______________________________________(of Candidate_________________________________) Signature of Presiding Officer.
85
PART-II DECLARATION AT THE END OF POLL I have furnished to the polling Agents, who were present at the polling station at the close of the poll and whose signatures are affixed below, an attested copy each of the entries in the ballot paper account in Form No.20.
Place :
Date: Signature of Presiding Officer.
RECEIVED AN ATTESTED COPY OF THE ENTRIES MADE IN THE BALLOT PAPER ACCOUNT Signature of Polling Agents:-
1._______________________________________(of Candidate_________________________________)
2._______________________________________(of Candidate_________________________________)
3._______________________________________(of Candidate_________________________________)
4._______________________________________(of Candidate_________________________________)
5._______________________________________(of Candidate_________________________________)
6._______________________________________(of Candidate_________________________________)
7._______________________________________(of Candidate_________________________________)
8._______________________________________(of Candidate_________________________________)
9.________________________________________( of Candidate_______________________________) 86 The following polling Agents who were present at the close of the poll declined to receive an attested copy of the ballot paper account and to give a receipt therefor and so an attested copy of the ballot paper account was not supplied to them.
1._______________________________________(of Candidate_________________________________)
2._______________________________________(of Candidate_________________________________)
3._______________________________________(of Candidate_________________________________)
4._______________________________________(of Candidate_________________________________)
5._______________________________________(of Candidate_________________________________)
6._______________________________________(of Candidate_________________________________)
7._______________________________________(of Candidate_________________________________)
8._______________________________________(of Candidate_________________________________)
9.________________________________________( of Candidate_______________________________) Place :
Date: Signature of Presiding Officer.
87 FORM 13 LIST OF CHALLENGED VOTES [See Rule 45 (2) (C)] Election of Member/Members to Ward No._______ of the _______ Village Panchayat/Panchayat Union Council/District Panchayat.
President to ______________________________________________Village Panchayat.
Number and Name of the Polling Station: ______________________________________________________________________ Date of Poll : _____________________________________ Sl.No.
of entry Name of Elector Name of Father/ Husband Sl.No. of Part of Roll.
Signature or thumbimpression of the Person challenged.
Address of the person challenged.
Name of Identifier, if any.
Name of Challenger.
Order of Presiding Officer.
Signature of Challenger, on receiving refund of deposit.
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Place:
Date: Signature of Presiding Officer.
88 FORM 14-A BALLOT PAPER [See Rule 49 (1)] _______________________________District Panchayat/Panchayat Union Council/1[***] _______________Ward No._______________ Electoral Roll Part number __________________Ward No._________________of ________________________Village Panchayat Sl.No.
of the elector _________________________________ Signature or Thumb impression of the elector.
…………………………………………………………………………………………………………………………………………………………………………………………………………………….
______________________________District Panchayat / Panchayat Union 1[***] _______________________Ward No._______ NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL
1. The words "President of Village Panchayat" were omitted by G.O.Ms.No.175, Rural Development(Panchayat Elections) dated 28th August 1996.
89 FORM 14-B BALLOT PAPER FOR ELECTION OF 1[PRESIDENT /MEMBER OF A VILLAGE PANCHAYAT] [See Rule 49 (2)] _______________________________ Panchayat Ward No.____________________ Electoral Roll Part No.________________________________ Sl.No. of the elector _________________________________ …………………….…………………………………………………… Signature or Thumb impression of the elector.
………………………………………………………………………………………………………………………………………………………………………………………………………………….
Election to 1[President / Member of a Village Panchayat] NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL NAME SYMBOL
1. Substituted by G.O.Ms.No.175, Rural Development (Panchayat Elections) Dept., dated 28th August 1996.
90 FORM 15 APPLICATION BY AN ELECTOR ON ELECTION DUTY TO VOTE [See Rule 52 (1)] To The Returning Officer, ___________________________Village Panchayat /Panchayat Union Council / District Panchayat.
Sir, I have been posted for election duty at the ensuing Member/Members to ward No._________________of the ___________Village Panchayat / Panchayat Union Council / District Panchayat election of President to ____________________________________Village Panchayat at the polling station No.______________________ situated in the ____________________Village Panchayat in ______________________________ Panchayat Union.
I hereby declare that I am an elector of ward number ___________ of the _________________Village Panchayat / Panchayat Union / District Panchayat. I have been enrolled under serial number ____________________of part number _______in the electoral roll of the ward No._______________of _______________________Village Panchayat.
I request that a certificate in Form 16 with a ballot paper may be sent to me to the address given below to enable me to cast my vote at the above election.
My address : ______________________ ______________________ __________________________ Date: Signature of elector on election duty.
NOTE.- Separate application shall be made for each election.
91 FORM 16 ELECTION DUTY CERTIFICATE [See Rule 52 (1)] Certified that _____________________________________________ is an elector in a ward No.____________________ of _________________________________Village Panchayat/ Panchayat Union Council/District Panchayat. His electoral roll particulars are given below:- Serial No.
Part No.
Ward No.
Village Panchayat Certified also that by reason of 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 through postal ballot paper in the manner laid down in Rule 52.
Place :
Date : Signature of Returning Officer.
Seal 92 FORM 17 DECLARATION BY ELECTOR [See Rule 52 (2)] Election of Member/Members to Ward No._________of the______ Village Panchayat/Panchayat Union Council/District Panchayat.
President to ____________________________________________Village Panchayat.
I hereby declare that I am the elector to whom the postal ballot paper bearing serial number _____________has been issued at the above election. I declare that I have marked my vote myself on the ballot paper.
Place :
Date : Signature of elector.
Address: __________________________________ _________________________________________ _________________________________________ 93 FORM 18 LIST OF BLIND AND INFIRM ELECTORS [See Rule 53 (2)] Election of Member/Members to Ward No.________ of the _________Village Panchayat/Panchayat Union Council/District Panchayat.
President to ____________________________________________ _ Village Panchayat.
Name of the Polling Station and Number :_____________________________________________________________ Ward number and serial number of elector Full name of elector Full name of companion Address of companion Signature of companion
(1) (2) (3) (4) (5) Place:
Date: Signature of Presiding Officer.
94 FORM 19 LIST OF TENDERED VOTES [See Rule 55 (2)] Election of Member/Members of Ward No.____of the __________ Village Panchayat/ Panchayat Union Council/District Panchayat.
President to ____________________________________________Village Panchayat.
Number and name of the Polling Station : __________________________________________________ Serial number Serial Number, part number, Ward number and name of elector.
Address of elector Serial number of tendered ballot paper Signature or thumbimpression of person tendering vote.
(1) (2) (3) (4) (5) Place:
Date : Signature of Presiding Officer.
95 FORM 20 [See Rules 58 (4)(a) and 64(2)] Election of Member / Members to ward No.__________ of the _______Village Panchayat / Panchayat Union Council / District Panchayat.
President to _______________________________________________Village Panchayat.
PART-I BALLOT PAPER ACCOUNT Name of the District Panchayat Ward No.
Name of the Panchayat Union Ward No.
Name of the Village Panchayat Ward No.
Number_____Name of Polling Station Serial Numbers Total Number From To
(1) (2) (3) (4)
1. Ballot papers received.
2. Ballot papers unused (i.e. not issued to voters)-
(a) With the signature of Presiding Officer
(b) Without the signature of Presiding Officer TOTAL: (a+b)
3. *Ballot papers used at the polling station (1-2=3)
4. *Ballot papers used at the polling station but NOT INSERTED INTO THE BALLOT BOX-
(a) Ballot papers cancelled for violation of voting procedure under Rule 54
(b) Ballot papers cancelled for other reasons
(c) Ballot papers used as tendered ballot papers TOTAL : (a+b+c) 96
5. *Ballot papers to be found in the ballot box (3-4=5) (*Serial numbers need not be given) Place :
Date : Signature of Presiding Officer.
PART-II RESULT OF INITIAL COUNTING
1. Total number of ballot papers that should be found in the ballot box(es) as shown in item 5 of Part I.
2. Total number of ballot papers actually found in the ballot box(es) as per initial counting.
3. Discrepancy, if any.
Place :
Signature of Counting Supervisor.
Date :
Signature of the Returning Officer.
97 FORM 21 APPOINTMENT OF COUNTING AGENTS [See Rule 60] Election of Member / Members to Ward No. _____ of the _________Village Panchayat/Panchayat Union Council/District Panchayat President to_____________________________________________Village Panchayat.
To The Returning Officer I, _______________________________________________________________________________________________, a Candidate / the Election Agent of __________________________________________________ who is Candidate at the above election do hereby appoint the following person as my counting agent to attend the counting of votes at __________________ His recent photograph, duly attested by me is pasted below- Place :
Date : Signature of Candidate or election Agent.
Name of the counting Agent Address of the counting Agent 98 I agree to act as such counting agent.
Place:
Date : Signature of counting Agent.
DECLARATION OF COUNTING AGENT TO BE SIGNED BEFORE THE RETURNING OFFICER I hereby declare that at the above election I will not do anything forbidden by section 58 of the Tamil Nadu Panchayats Act, 1994 which I have read / has been read over to me.
Signature of Counting Agent.
Place:
Date :
Signed before me.
Place:
Date :
Signature of the Returning Officer.
TO BE HANDED OVER TO THE COUNTING AGENT FOR PRODUCTION AT THE COUNTING CENTRE Section 58 of the Tamil Nadu Panchayats Act, 1994.
“Every Officer, Clerk, agent or other person performing any duty in connection with the recording or counting votes at an election who, except for some purpose authorized by law, communicates to any person any information showing directly or indirectly for which candidate any voter ha voted, and every person, who by any improper means procures any such information, shall be punished with imprisonment which may extend to six months or with fine, or with both”.
99 FORM 22 RESULT SHEET [See Rules 64(2), 66(1), (4)(b), (5), 67(1)(d), (2)(d) and (3)(d)] Election of Member / Members to Ward No. _____ of the ______Village Panchayat / Panchayat Union Council / District Panchayat President to__________________________________________Village Panchayat.
Serial Number Name of the Candidate Votes secured through Postal ballot Votes secured at the Poling stations TOTAL 1 2 3 … TOTAL NUMBER OF VALID VOTES POLLED REJECTED VOTES TENDERED VOTES TOTAL Place:
Date : Returning Officer.
100 FORM 23 RETURN OF ELECTION [See Rule 67(1) (a), (2)(a)] Election of Member / Members to Ward No. _____ of the ______Village Panchayat / Panchayat Union Council / District Panchayat President to__________________________________________Village Panchayat.
Sl. No.
(1) Name of the Candidate
(2) Name of valid votes polled
(3) 1 2 3 … TOTAL NUMBER OF VALID VOTES POLLED TOTAL NUMBER OF REJECTED VOTES I declare that Thiru / Thirumathi / Selvi_______________________________________has been duly elected as the President of _____________________Panchayat Union Council / District Panchayat in ____________________________ward of _____________________________Panchayat Union Council / District Panchayat in ____________________________ Place:
Date :
Returning Officer.
101 FORM 24 RETURN OF ELECTION [See Rule 67(3) (a)] Election of Member / Members to Ward No. _________________ of _________________________________Village Panchayat.
Sl. No.
(1) Name of the Candidate
(2) Name of valid votes polled
(3) 1 2 3 … TOTAL NUMBER OF VALID VOTES POLLED TOTAL NUMBER OF REJECTED VOTES I declare that the following Candidate has / candidates have been duly elected to the seat / seats specified against him name or names:- Name of the elected Candidate
(1) Seat to which he is elected
(2) Place:
Date : Returning Officer.
102 FORM 25 DECLARATION OF THE RESULT OF ELECTION.
(See 1[Rule 69] (1), (2), (3)] Election of Member/ Members to Ward No.____ of the _________ Village Panchayat/ Panchayat Union Council/ District Panchayat.
President to ___________________________________________Village Panchayat.
DECLARATION In pursuance of the provisions contained in sub-rule (1)(2) (3) of Rule 70 of the Tamil Nadu Panchayats (Elections) Rules, 1995, I declare that- Thiru/Tmt/Selvi.__________________ ________________________________ ________________________________ has been duly elected as member from Ward No. ________________ of ___________ Panchayat Union Council/District Panchayat/ President of __________ Village Panchayat of _______________ District.
Place :
Date: Returning Officer.
1. Substituted by G.O.Ms.No.175, Rural Development (Panchayat Elections) Dept., dated 28th August 1996.
103 FORM 26 DECLARATION OF THE RESULT OF ELECTION.
[See Rule 69 (4)] Election of Member/ Members to Ward No.___________of the _______________________________________ Village Panchayat.
DECLARATION In pursuance of the provisions contained in sub-rule (4) of Rule 69 of the Tamil Nadu Panchayats (Elections) Rules, 1995, I declare that the following Candidate has/candidates have been duly elected to the seat/seats specified against his name/their names:- Name of the elected Candidates
(1) Seat to which he is elected
(2) • Here indicate SC/ST 1[***] Women/Open seat etc.
Place :
Date: Returning Officer.
1. The words “for B.C.” omitted by G.O.Ms.No.163, Rural Development Department, dated 7th August 1996.
104 FORM 27-A NOMINATION FORM [See Rule 75(1)] Election of Chairman/Vice- Chairman of the ____________________ Panchayat Union Council/ District Panchayat.
Vice-President to ________________________________________ Village Panchayat.
I, Thiru/Tmt/Selvi ____________________________________________________________________ member from ward No.
__________________ hereby nominate Thiru/Thirumathi/Selvi__________________________________ member from Ward No.________, as a Candidate for the election of Chairman/Vice-Chairman of the _____________________ Panchayat Union Council/ District Panchayat/ Vice-President of _____________________________ Village Panchayat.
Place :
Date : Signature of Proposer.
I, Thiru/Thirumathi/Selvi _________________________________ member from ward No.___________________, hereby second the above nomination.
Place :
Date : Signature of the Seconder.
DECLARATION OF THE CANDIDATE.
I, Thiru/Thirumathi/Selvi _______________________________________ member from ward No._____________, hereby assent to this nomination.
Place :
Date : Signature of the Candidate.
Form 27-B was omitted by G.O.Ms.No. 282 (Rural Development) (C4), dated 30th October 2000.
105 FORM 28-A BALLOT PAPER [See Rule 82(1)] ELECTION OF CHAIRMAN/VICE-CHAIRMAN-VICE PRESIDENT Serial Number :
NAME :
WARD NUMBER :
NAME :
WARD NUMBER:
NAME :
WARD NUMBER:
NAME :
WARD NUMBER:
Returning Officer.
Form 28-B was omitted by G.O.Ms.No.282 (Rural Development (C4), dated 30th October 2000.