FORM 'X' {RULE 61(5)(a)} Nomination Form for election to the committee of ............................. Society. 1. Name of the Candidate .................................... 2. Membership No. ........................................ (with classification , if any) 3. Father or Husband's Name..................................... 4. Full Address of the Candidate ................................ 5. In case the candidate is seeking ................................. election to represent any society , mention the name of the society. 6. Proposer's name and his membership No. ............................ 7. Signature or thumb impression of the Proposer .......................... 8. Secondar 's name and his membership No. ........................... 9. Signature or thumb impression of the Secondar 10. Symbol which he desires to use for the election ........................ DECLARATION 11. I hereby declare that I am willing and eligible under Tripura cooperative Societies Act , Rules and Bye-laws of the society to stand for the election of committee members Signature or thumb impression of the candidate Endorsement by the election officer The nomination was presented to be in person at ...... on ........ date at ......... ........ hours by him. Signature of the Election Officer
