ADDITIONAL IMPORTANT INFORMATION FROM ELECTORAL OFFICER, LAWRENCE LEWIS ELECTORS ARE REMINDED OF THE FOLLOWING IMPORTANT ELECTION CODE REQUIREMENTS IN ORDER TO RECEIVE A MAIL-IN BALLOT PACKAGE YOU MUST MAKE THE REQUEST USING THE PRESCRIBED FORM PROVIDED BY THE ELECTORAL OFFICER (ALSO ATTACHED TO THIS DOCUMENT AND AVAILABLE ON THE ELECTION WEBSITE). ST ELECTION DAY – JUNE 1 , 2015 YOU MAY MAKE YOUR NOMINATION/SECOND USING THE PRESCRIBED FORMS (CANDIDATE DECLARATION & NOMINATION DECLARATION) AND SUBMIT THEM TO THE ELECTORAL OFFICER PRIOR TO THE START OF THE NOMINATION MEETING (ALSO ATTACHED TO THIS DOCUMENT AND AVAILABLE ON THE ELECTION WEBSITE). NOMINATION DAY – APRIL 17TH, 2015 PLEASE DO NOT HESITATE TO CONTACT THE ELECTORAL OFFICER AT ANY TIME – HE WILL BE PLEASED TO ANSWER YOUR QUESTIONS AND ASSIST YOU WITH ANY PROCESS OR ELECTION REQUIREMENTS. FOR MORE INFORMATION PLEASE CONTACT LAWRENCE LEWIS, ELECTORAL OFFICER Ph/Txt: 250 889-1582 Fax: 250 384-5416 Email: [email protected] PO Box 35008 Hillside, Victoria, BC V8T 5G2 WWW.HFN-ELECTIONS.CA Haisla Nation Nomination/Second Declaration Form NOMINATION/SECOND DECLARATION I swear and affirm that I am a registered Elector of the Haisla Nation pursuant to the Haisla Nation Custom Election Code (2013), at the address listed below and understand the nature of the vote and that I make this declaration freely and without compulsion, AND WITH REGARD TO THIS ELECTION I make the following Nomination(s) and/or Second(s): Name of Person Nominate for Chief or Councillor COUNCILLOR COUNCILLOR COUNCILLOR COUNCILLOR COUNCILLOR 1. 2. 3. 4. 5 Electors may use this form for either Nominating or Seconding. THIS SECTION TO BE COMPLETED AT THE NOMINATION MEETING BY THE PERSON MAKING THE NOMINATION/SECOND DECLARATION. Full Legal Name: Date of Birth (dd/mm/yyyy): Registry Number: Phone Number: On-Reserve: YES Email: Date: Signature WITNESS DECLARATION I swear and affirm that I have witnessed the signature of the Haisla Elector above. Full Legal Name: Phone: Email: X. Date: Witness Signature / NO 2015 Haisla Nation Election Request for Mail in Ballot I, __________________________________________________________, swear and declare that I am an Elector of the Haisla Nation, and wish to obtain a mail-in ballot package from the Electoral Officer as prescribed and pursuant to the HAISLA NATION CUSTOM ELECTION CODE (2013), and that the information contained in the Section below is truthful and accurate. COMPLETE THESE SECTIONS IN FULL – IF THESE SECTIONS ARE INCOMPLETE YOU MAY NOT RECEIVE A MAIL-IN BALLOT PACKAGE Full Legal Name: Mailing Address: City & Province: Postal Code: Registry Number: Phone Number: Date of Birth (dd/mm/yyyy): Email: Date: Signature: WITNESS DECLARATION I swear and affirm that I have witnessed the signature above. Full Legal Name: Phone: Email: Date: Witness Signature: Please complete in full, sign, have witnessed and remit immediately to: LAWRENCE LEWIS, HFN ELECTORAL OFFICER Ph/Txt: 250 889-1582 Fax: 250 384-5416 Email: [email protected] PO Box 35008 Hillside, Victoria, BC V8T 5G2 WWW.HFN-ELECTIONS.CA
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