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[See rule 25 (4) ]
Revocation of Appointment of Polling
Agent
Election to the * …………………………………………….Grama ** /Taluk/Zilla Panchayat
from the * ……………………………..Constituency
To:
The Presiding Officer:
………………………
………………………
I, ……………………………. a Candidate / the Election Agent of ………… at the
above election hereby revoke the appointment of ………………………. Polling
Agent ……………………………………………………………. at the Polling Station No……………………….
at ………………………………(place)
Place :
| Date |
Signature of the Candidate
** /Election Agent
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* Appropriate particulars of the election to be inserted here.
** Strike off the inappropriate alternative.
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