Western Australian Consolidated Regulations

POLICE APPEAL BOARD (ELECTION) REGULATIONS 2007 - SCHEDULE 1

[r. 7(1)(a), 22(1)]

1 .         Nomination by candidate

NOMINATION FOR ELECTION FOR MEMBER OF THE POLICE APPEAL BOARD

Candidate’s details

Title

Surname

Given names

Name requested to be shown on ballot paper

Postal address

No.

Street name

Suburb/Town

Postcode

Telephone numbers

(H)

(W)

Fax number

Email

Signature of candidate

Date / /

Nominations must be received by the returning officer before (date and time for the close of nominations to be inserted here) , the date and time for the close of nominations.

(Name and address of returning officer to be inserted in this box)

(Telephone and facsimile number and email address (if any) of the returning officer to be inserted in this box)

2 .         Appointment of scrutineer

APPOINTMENT OF SCRUTINEER FOR THE ELECTION OF MEMBER OF THE POLICE APPEAL BOARD

Candidate’s details

Title

Surname

Given names

Postal address

No.

Street name

Suburb/Town

Postcode

I appoint the following person as a scrutineer for the above election.

Signature of candidate

Date / /

Scrutineer’s details

Title

Surname

Given names

Postal address

No.

Street name

Suburb/Town

Postcode

Telephone numbers

(H)

(W)

Fax number

Email

I DECLARE that I will observe the election processes and comply with lawful directions given by the returning officer.

Signature of scrutineer

Date / /