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Ratepayers Victoria Inc: A00040924M

NOMINATION FORM FOR ELECTION OF COMMITTEE

This form or a photocopy shall be used for the nomination of any candidate for the following positions:

President, Vice President, Secretary, Treasurer, (2) Ordinary member of Ratepayers Victoria

MEMBER NOMINATED............................................................................................................................…………………..…

(Please Print Name)

ADDRESS…………………………………………………………………………………...Postcode……………..………

SIGNATURE

 (See Note 2) …………………………………………………………………………………Date….….../………../............

POSITION

(See Note1) ........................................................................................................................................................................................

PROPOSER..................................................................................................................................Phone............................................

^{(Please Print Name)}

SIGNATURE OF

PROPOSER……………………………………………………..……………………..……..Date…….…../……..…/…...........

SECONDER.................................................................................................................................Phone............................................

^{(Please Print Name)}

SIGNATURE OF SECONDER.................................................................................................................................Date............./………/.............

Note 1:             President, Vice President, Secretary, Treasurer, 2 Ordinary members on the Management Committee.

Note 2:             It is mandatory that this nomination is endorsed with the signature of the Financial candidate being nominated; their acceptance of the nomination will be checked by the Returning Officer.

Note 3:             A separate form must be used for each candidate and for each position.

Note 4:             All nomination forms must be forwarded to the Returning Officer on or before the due date.

Nomination forms for the Election of Committee should be forwarded in a separate, sealed envelope addressed to: The Returning Officer, Ratepayers Victoria Inc: 8/1248 North Road Oakleigh Sth 3167

RATEPAYERS VICTORIA, Inc. A0040924M