form 36 Nomination Paper for election

…………………………… SERVICE CO-OPERATIVE BANK LTD NO ………..

……………………………….(Place)

FORM NO. 36

(See Rule  35 A (6) (a))

NOMINATION PAPER

Electionto the Board of Directors of ………………………… Service Co-operative Bank Ltd…………… proposed to be held on ……………………..

1. (a) Full Name of the Candidate                              :                      

    (b)  Postal Address                                                :                        

    © Member No.                                                     :

    (d) Male\Female                                                    :

    (e) Age and Date of Birth                                       :

    (f) Ward\Region in which Contesting                      :

2. (a) Name of Proposer                                            :

    (b) Postal Address                                                 :

    ©  Member No.                                                    :

    (d) Male\Female                                                    :

    (e) Age and Date of Birth                                       :

3. (a) Name of Seconder                                           :

    (b) Postal Address                                                 :

    ©  Member No.                                                    :

    (d) Male\Female                                                    :

    (e) Age and Date of Birth                                       :

                                                            Signature of the Candidate :

                                                            Signature of the Proposer   :

                                                           Signature of the Seconder    : 

DECLARATION OF PROPOSER

I, ………………………………………………. (name) Member No ………………….

of  ……………………………….Service Co-operative Bank Ltd. No ……………..dated ……………….. hereby propose Shri…………………………………………Member No…………… as a candidate for election to the Board of Directors of the above bank proposed to be hald on …………………….  I also declare that the details furnished above are correct.

Place:                                                                       Signature of the Proposer  

Date:                                                                        Name.

DECLARATION OF SECONDER

I, …………………………………………………(name) Member No …………………

of  …………………………………………..Service Co-operative Bank Ltd No ………...

dated ……………………. hereby second the nomination of Shri………………………...

Member No ………………. as a Candidate for election to the Board of Directors of the above bank proposed to be held on ………………………..  I also declare that the details furnished above are correct.

Place:                                                                       Signature of the Seconder  

Date:                                                                        Name:

DECLARATION OF THE CANDIDATE

I, ……………………………………………………….(name) Member No ……………..

hereby declare that I am willing to contest as a Candidate to the election to the Board of Directors of  …………………………………. Service Co-operative Bank Ltd ………….

to be held on ………………………  I may also declare that I have no disqualification under the Kerala Co-operative Societies Act, Rules and bye-laws of the bank to be elected to the Board of Directors of the above bank.

Place:                                                                        Signature of the Candidate

Date:                                                                         Name.

DECLARATION OF THE CANDIDATE

CONTESTING TO THE SEAT RESERVED FOR SC\ST

I, …………………………………………………. (name) Member No ………………..

hereby declare that I am included in ………………………………………..………(caste)

………………………………………….(religion) and I am qualified to contest for election in the seat reserved for the SC\ST candidate to the election to the Board of Directors of …………………………………… Service Co-operative Bank Ltd…..…

proposed to be held on …………………………..

Place:                                                                          Signature of the Candidate

Date:                                                                           Name

To be filled by the Returning Officer:

Sl No………………..

This nomination paper was filed by Shri…………………………………… candidate\ proposer\seconder before me at ……………………….(time) on …………………. (date)

Place:                                         

Date:                                                                                             Returning Officer

ORDER PASSED BY THE RETURNING OFFICER AT THE TIME OF

SCRUTINY OF THE NOMINATION PAPER

I have examined the nomination paper as per the provisions of the Kerala Co-operative Societies Act\Rules and bye-laws of the Bank and my decision is noted below.

                                                       ……………………………………………………….

                                                       ……………………………………………………….

                                                       ……………………………………………………….

Place:

Date:                                                                                      RETURNING OFFICER