FORM - III


FORM – III
Nomination form for elections of Board of Directors
[See paragraph 3 (a) of the Schedule]

 1. Name of the Multi-State Cooperative Society and Address  :                                                                                                         
2. Name of the candidate in case of an Individual member or name of the delegate and the member cooperative Society or multi-state cooperative society which he is representing :  
3. Serial no. in the register of members    
4. Father’s or husband’s name (in case of individual member)    
5. Address    
6. Name of the proposer in case the proposer is an individual member and the name of the society and The delegate in the case proposer Is a delegate of a society    
7. Serial no. of the proposer in the Register of members    
8. Signature of the proposer    
9. Name of the seconder when the seconder is an individual member and name of the society    
10. Serial no. of the seconder in the register of members    
11. Signature of the seconder    

CANDIDATES DECLARATION
        
           I declare that I am willing to stand for election and that, to the best of my knowledge and belief I have not incurred any disqualification for membership of the board of ______________ multi-state cooperative society in terms of the Act, the rules and the bye-laws of the multi-state cooperative society.

(Signature of the candidate)


ENDORSEMENT BY THE RETURNING OFFICER

        
              This nomination paper was presented to me in person by ___________/ received by registered post on _____ at _____ hrs.

Place _________
Date _________

Signature of Returning Officer Or person authorized by him

  
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