FORM V - Nomination form for election of office bearers - Multi-State Cooperative Societies Rules, 2002

FORM V [See sub-paragraph (3) of paragraph 7 of the Schedule] Nomination form for election of office bearers 1. Name of the multi-state cooperative : and address 2. Office for which contesting : 3. Name of the candidate in case on an individual member or name of the delegate and the member cooperative society or multi-state cooperative society which he is representing : 4. Serial No. in the register of members : 5. Father s or husband s name (in case of Individual member) : 6. Address : 7. 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 : 8. Serial No. of the proposer in the : Register of members 9. Signature of the proposer : 10. Name of the seconder when the seconder is an individual member and name of the society and the delegate in case the seconder is a delegate of a society : 11. Serial No. of the seconder in the register of members : 12. Signature of the seconder : CANDIDATE S DECLARATION I declare that I am willing to stand for election of office of the President/Chairperson/Vice-President/ Vice-Chairperson (specify for any other office) 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 The 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