FORM I (FRONT)

[Clauses 67(3)(a),(b),(c),(d),(g) & (h) and subsections 67(3), (4) & (5) of the Act] [Subsection 37(1) of the Regulations]

Nomination
We the undersigned, being voters of the:

Rural Municipality of Excelsior No. 166

                Division No.	 (if applicable)	
nominate  ______________________________	  ,

of 	, to be a candidate at the election
(legal description of land)

to be held on the 9th day of November, 2022 for the office of:
(Place ‘X’ in box beside one)
	Reeve: Rural Municipality of Excelsior No. 166	
		
  X	Councillor: Rural Municipality of Excelsior No. 166

     Division No.		

Signature *	Name (printed)	Legal Description of Land		

FORM I (BACK)

[Clauses 67(3)(a)(b)(c)(d)(g) & (h) of the Act] [Subsection 37(1) of the Regulations]

Candidate’s Acceptance
I, 	,
(Name as it will appear on the ballot)
a candidate nominated for the office of: (complete as applicable)

(Place ‘X’ in box beside one)
	Reeve: Rural Municipality of Excelsior No. 166	
		
   X	Councillor: Rural Municipality of Excelsior No. 166

     Division No.		
declare that:
1	I am the full age of 18 years or will attain the full age of 18 years on or  before election day;
2	I am a Canadian citizen;
3	If elected, I will accept the office for which I was nominated; and
4	I am not disqualified by The Local Government Election Act, 2015 or any other Act from holding the office for which I am a candidate
5	I am eligible to vote in the municipality
6	I am a resident of Saskatchewan.

Dated at 					, this 		 day of 			, 2022.

							
Candidate Signature
	
Can