FORM – IV
[See paragraph 5 (b) of the Schedule]
Application for appointing election agent
I, ____________________ name of father/spouse ________________member of _____________ (name of the society) contesting for election of members of board of directors/office bearers do hereby nominate the following person an my election agent/counting agent in the election _____________(name of the society) to be held on _____________(specify the date).
Name and Signature of the candidate