#922877
an...............lá so de............................................................................................., 19............
Dated this ....................................... day of ......................................................., 19................................ Presidential Returning Officer. *Insert here the full name of the candidate, surname first. † Insert here the full postal address of the candidate. ‡ Insert here the rank, profession, or occupation of the candidate. *Insert here the full name of the candidate, surname first. †Insert here the full postal address of the candidate. ‡Insert here the rank, profession, or occupation of the candidate. * Insert here the full name of the nominator, surname last. † Insert here the full postal address of the nominator. ‡ Insert here the rank, profession, or occupation of the nominator. * Insert here the full name of the nominator, surname last. † Insert here the official residence of the nominator.