| FORM
D
[
Section 23 (2) ]
ELECTION
OFFENCES ACT 1954
STATEMENT
ON OATH BY AN ELECTION AGENT
I, ................................................................................................................................
Identity Card No. .....................................................
of .................................................................................................................
being appointed election agent for ..............................................................................................................................
a candidate for election in the ...............................................................................................................................
constituency/electoral ward, do hereby solemnly affirm (or swear)
that the accompanying return respecting election expenses is,
to the best of my knowledge and belief, true, and that, except
the expenses therein set forth, no expenses of any nature whatsoever
have to my knowledge or belief been incurred in or for the purpose
of candidature of ........................................
................................................................................................................
Dated this
......................................... day of ......................................
20 ..................
| ..............................................................................
Election Agent |
Solemnly affirmed
(or sworn to) before me.
.....................................................................
Chairman or Member of the Election Commission.
Magistrate.
Justice of the Peace.
Commissioner for Oaths.
State Elections Officer.
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