Part II Regulations under the Regulations Act Printed by the Queen's Printer Halifax, Nova Scotia Vol. 24, No. 15 July 28, 2000 Contents Act Reg. No. Page Municipal Elections Act M u n i c i p a l E l e c t i o n s F o r m s - A m e n d m e n t .................130/2000 484 NOW AVAILABLE The third issue for the 2000 subscription year of the Folio®-based Nova Scotia Regulations CD-ROM, containing the consolidated regulations of Nova Scotia and the quarterly sectional index of regulations, is now available from the Office of the Registrar of Regulations. For information or subscriptions please call (902) 424-6723 or visit our website at www.gov.ns.ca/just/regulations/cd. 483

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Part II Regulations N.S. Reg. 130/2000 Made: July 11, 2000 Filed: July 13, 2000 Municipal Elections Forms Order dated July 11, 2000 Amendment to regulations made under subsection 167(1) of the Municipal Elections Act 1 Forms 8A, 8B, 8C, 9A, 24A, 31C and 31D made pursuant to subsection 167(1) of

Chapter 300 of the Revised Statutes of Nova Scotia, 1989, the Municipal Elections Act, are repealed. 2 Forms 6, 6A, 8, 9, 11, 11A, 11B, 11C, 12, 14, 17, 20, 30, 31, 31A, 31B, 33, 34, 38 and 39 are repealed and Forms 6, 6A, 8, 9, 11, 11A, 11B, 11C, 12, 14, 17, 20, 30, 31, 31A, 31B, 33, 34, 38 and 39 in the form set forth in

Schedule “A”, attached, are substituted, pursuant to subsection 167(1) of

Chapter 300 of the Revised Statutes of Nova Scotia, 1989, the Municipal Elections Act. 3 Forms 34A, 42, 43, 44 and 45 in the form set forth in

Schedule “A”, attached, are prescribed pursuant to subsection 167(1) of

Chapter 300 of the Revised Statutes of Nova Scotia, 1989, the Municipal Elections Act. July 11, 2000 (Signed) Angus MacIsaac Minister of Housing and Municipal Affairs 484

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Part II Regulations

Schedule “A” Form 6

Section 25 Index Sheet (Alphabetical) Polling Division Number ________ Consecutive Number Name (Surname First) Civic Address Mailing Address (if necessary) Postal Code (if necessary) 485

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Part II Regulations Form 6A

Section 25 Index Sheet (by Civic Address) Polling Division Number_____________ Consecutive Numbers Civic Number Name (Surname First) Mailing Address (if necessary) Postal Code (if necessary) (NAME OF STREET/A VENUE/ROAD/HIGHWAY AND COMMUNITY): (insert name) (NAME OF STREET/A VENUE/ROAD/HIGHWAY AND COMMUNITY): (insert name) 486

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Part II Regulations Form 8

Section 36 Oath or Affirmation of Elector Applying to be Added to the List of Electors at Revision I swear (or solemnly affirm) that 1. On this date I actually reside in Polling Division Number ______ of Polling District Number ______ of the Town/Municipality/Regional Municipality of __________________________________________________________. 2. I have been ordinarily resident in the municipality for a period of three months immediately preceding ordinary polling day in this election and continue to so reside. 3. I am a Canadian citizen and am of the full age of eighteen years, or will be on ordinary polling day.

Name of Elector Address of Elector Signature of Elector (PLEASE PRINT) Sworn (or affirmed) at ______________ in the County of ___________________ this _____ day of ___________________, _______, before me _________________________________ Revising Officer 487

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Part II Regulations Form 9

Section 36 Oath or Affirmation of Person Applying for Amendment of the List of Electors at Revision I _______________________ of __________________________________, swear (name) (address) (or solemnly affirm) that I believe that _________________ of ________________, (name) (address) registered on the list of electors for Polling Station Number _______ in Polling District Number _______, should not be on the list because (place a check mark next to the applicable statement) _____ he/she does not reside at the address shown; _____ he/she is not the full age of eighteen years and will not be on ordinary polling day; _____ he/she is not a Canadian citizen; _____ he/she has not been ordinarily resident in the municipality for three months immediately preceding ordinary polling day; _____ he/she is dead.

Sworn (or affirmed) at ________________ in the County of _____________________ this ______ day of ____________________, ______, before me Revising Officer Applicant 488

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Part II Regulations Form 11

Section 44 Nomination Paper (Mayor or Other Council Member) We, the qualified electors whose names appear on the final list of electors of the Town/Municipality/Regional Municipality of ______________________, nominate _______________________________ of _________________________________ (name) (address) as a candidate for the office of _____________________ for the election to be held on the _____ day of _________________, ______.

SIGNED: Name Civic Address Signature (please print) (Note: These electors must be qualified to vote at the election of the candidate.) Consent and Oath or Affirmation of Candidate I solemnly swear (or affirm) that: 1. I (He/She), _____________________________________________________, (name as it should appear on the ballot paper) consent(

s) to the nomination. 2. I am (He/She is) a Canadian citizen. 3. I am (He/She is) of the full age of eighteen years. 4. I have (He/She has) been ordinarily resident in the Town/Municipality/Regional Municipality of ________________________________, or in an area annexed to the Town/Municipality/Regional Municipality, for a period of six months preceding nomination day. 5. I am (He/She is) not indebted to the Town/Municipality/Regional Municipality of ________________________________ for any rates, taxes or other charges, or interest related to any of these, and a certificate from the ________________ to this effect is attached. 489

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Part II Regulations 6. I have (He/She has) not been convicted of bribery or of committing a corrupt practice under the Municipal Elections Act within the five years preceding nomination day. 7. I have (He/She has) read the sections of the Municipal Elections Act related to persons disqualified to vote, to be nominated or to serve on a council and none of the reasons for disqualification listed in those sections apply to me (him/her). 8. I (He/She) will accept the office of ________________________ if elected. 9.

I appoint (He/She appoints) __________________________________ of ____________________ as my (his/her) official agent under the Municipal Elections Act. Sworn (or affirmed) at ______________ in the County of ____________________ this ______ day of ____________________ ______, before me (see

Section 146) Candidate (or Agent if authorized and the authorization is attached) Receipt Received from the above-named candidate or from his/her agent on his/her behalf a completed nomination paper and the sum of _________ in legal tender or a certified cheque or money order made payable to the Town/Municipality/Regional Municipality of ____________________________________ as a deposit pursuant to the Municipal Elections Act. Dated at ________________ this _________ day of ________________, _______ Returning Officer 490

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Part II Regulations Form 11A

Section 44 Nomination Paper (District Member, ___________________ Regional/District School Board) We, the qualified electors whose names appear on the final list of electors of the Town/Municipality/Regional Municipality of _____________________________, nominate _______________________ of _________________________________ (name) (address) as a candidate for the office of member of the ________________________ for the (regional or district school board) election to be held on the _______ day of __________________, ______.

SIGNED: Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature (Note: These electors must be qualified to vote at the election of the school board candidate.) .................................................................... 491

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Part II Regulations Consent and Oath or Affirmation of Candidate I solemnly swear (or affirm) that: 1. I (He/She), _____________________________, consent(

s) to the nomination. (name as it should appear on the ballot paper) 2. I am (He/She is) a Canadian citizen. 3. I am (He/She is) of the full age of eighteen years. 4. I have (He/She has) been ordinarily resident in the school region/district for a period of six months preceding nomination day, and continue(

s) to so reside. 5. I have (He/She has) not been convicted of any corrupt practice or bribery under the Municipal Elections Act within the ten years preceding nomination day. 6. I have (He/She has) not been convicted of an offence referred to in

Section 46 of the Education Act. 7. I have (He/She has) read the sections of the Municipal Elections Act and the Education Act related to persons disqualified to vote, to be nominated or to serve on a school board and none of the reasons for disqualification listed in those sections apply to me (him/her). 8. I (He/She) will accept the office of district member of the _________ Regional/ District School Board if elected. 9. I appoint (He/She appoints ___________________ of _________________ as my (his/her) official agent under the Municipal Elections Act.

Sworn (or affirmed) at _______________ in the County of _____________________ this ______ day of _____________________, ______, before me (see

Section 146) Candidate (or Agent if authorized and the authorization is attached) Receipt Received from the above-named candidate or from his/her agent on his/her behalf a completed nomination paper and the sum of ________ in legal tender or a certified cheque or money order made payable to the Town/Municipality/Regional Municipality of ____________________________________ as a deposit pursuant to the Municipal Elections Act. Dated at _____________ this ____ day of _____________, _____ Returning Officer 492

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Part II Regulations Form 11B

Section 44

Section 13, Education Act Nomination Paper (Conseil Scolaire Acadien Provincial) We, the qualified electors whose names appear on the final list of electors for the municipality shown opposite each name, nominate: ________________________________ of ________________________________ (name) (address) as a candidate for the office of member of the Conseil scolaire acadien provincial for the election to be held on the _____ day of _______________, ______. (Note: Nominators to sign below and also to sign “Statment of Nominators”.) SIGNED: Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature (Note: These electors must be qualified to vote at the election of the school board candidate.) ........................................................................................ 493

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Part II Regulations Statement of Nominators Under the Education Act, only an “entitled person” may nominate a candidate for election as a member of the Conseil scolaire acadien provincial. Under the Education Act, an “entitled person” is defined to mean a person who is a Canadian citizen AND (

a) whose first language learned and still understood is French; OR (

b) who received his or her primary school instruction in Canada in a French-first- language program; OR (

c) who is the parent of a child who has received or is receiving primary or secondary school instruction in Canada in a French-first-language program (note that the definition of “parent” in respect to “entitled persons” does not include a guardian or person acting in loco parentis to a child). I state that I am an “entitled person” within the meaning of this definition. Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature ....................................................................

Consent and Oath or Affirmation of Candidate I swear (or solemnly affirm) that 1. I (He/She), ______________________________, consent(

s) to the nomination. (name as it should appear on the ballot paper) 2. I am (He/She is) a Canadian citizen. 3. I am (He/She is) of the full age of eighteen years. 4. I have (He/She has) been ordinarily resident in the province of Nova Scotia for a period of six months preceding nomination day, and continue(

s) to so reside. 5. Under the Education Act, an “entitled person” is defined to mean a person who is a Canadian citizen AND (

a) whose first language learned and still understood is French; OR 494

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Part II Regulations (

b) who received his or her primary school instruction in Canada in a French- first-language program; OR (

c) who is the parent of a child who has received or is receiving primary or secondary school instruction in Canada in a French-first-language program (note that the definition of parent does not include a guardian or person acting in loco parentis to a child). I state that I am an “entitled person” within the meaning of this definition. 6. I have (He/She has) not been convicted of any corrupt practice or bribery under the Municipal Elections Act within the ten years preceding nomination day. 7. I have (He/She has) not been convicted of an offence referred to in

Section 46 of the Education Act. 8. I have (He/She has) read the sections of the Municipal Elections Act and the Education Act related to persons disqualified to vote, to be nominated or to serve on a school board and none of the reasons for disqualification listed in those sections apply to me (him/her). 9. I (He/She) will accept the office of member of the Conseil scolaire acadien provincial if elected. 10. I (He/She) appoint(s) ______________________, of ____________________, (name) (address) as my (his/her) official agent under the Municipal Elections Act.

Sworn (or affirmed) at _______________ in the County of _____________________ this ______ day of _____________________, ______, before me (see

Section 146) Candidate (or Agent if authorized and the authorization is attached) Receipt Received from the above-named candidate or from his/her agent on his/her behalf a completed nomination paper and the sum of __________ in legal tender or a certified cheque or money order made payable to the Town/Municipality/Regional Municipality of ________________________ as a deposit pursuant to the Municipal Elections Act. Dated at _____________ this _____ day of ________________, _______ Returning Officer (A translation of this form is available in French.) 495

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Part II Regulations Form 11C

Section 44

Section 42A, Education Act Nomination Paper (African Nova Scotian Member, _________ Regional/District School Board) We, the qualified electors whose names appear on the final list of electors for the municipality shown opposite each name, nominate: ______________________ of ___________________________ as a candidate for (name) (address) the office of African Nova Scotian member of the _______________ Regional/ District School Board for the election to be held on the ___ day of _______, ____ . (Note: Nominators to sign below and also to sign “Statement of Nominators”.) SIGNED: Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature Name Civic Address Municipality (please print) Signature (Note: These electors must be qualified to vote at the election of the school board member.) .......................................................................... 496

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Part II Regulations Statement of Nominators Under the Education Act, only an “African Nova Scotian elector” may nominate a candidate for election as the African Nova Scotian member of a school board. Under the Education Act, an “African Nova Scotian elector” is defined to mean a person who is qualified to vote in an election of a school board AND (

a) who is an African Nova Scotian or a black person; OR (

b) who is the parent of an African Nova Scotian or a black person. I state that I am an “African Nova Scotian elector” within the meaning of this definition. Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature Name (Please Print) Signature Consent and Oath or Affirmation of Candidate I swear (or solemnly affirm) that 1. I (He/She), ______________________________, consent(

s) to the nomination. (name as it should appear on the ballot paper) 2. I am (He/She is) a Canadian citizen. 3. I am (He/She is) of the full age of eighteen years 4. I have (He/She has) been ordinarily resident in the School Region/District for a period of six months preceding nomination day, and continue(

s) to so reside. 5. Under the Education Act an “African Nova Scotian” is defined to mean a person who is an African Nova Scotian or a black person. I state that I am an “African Nova Scotian” within the meaning of this definition. 6. I have (He/She has) not been convicted of any corrupt practice or bribery under the Municipal Elections Act within the ten years preceding nomination day. 7. I have (He/She has) not been convicted of an offence referred to in

Section 46 of the Education Act. 497

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Part II Regulations 8. I have (He/She has) read the sections of the Municipal Elections Act and the Education Act related to persons disqualified to vote, to be nominated or to serve on a school board and none of the reasons for disqualification listed in those sections apply to me (him/her). 9. I (He/She) will accept the office of African Nova Scotian member of the ___________ Regional/District School Board. 10. I (He/She) appoint(s) _____________________ of _____________________ (name) (address) as my (his/her) official agent under the Municipal Elections Act. Sworn (or affirmed) at in the County of this day of , , before me (See

Section 146) Candidate (or Agent if authorized and the authorization is attached) Receipt Received from the above-named candidate or from his/her agent on his/her behalf a completed nomination paper and the sum of ______________ in legal tender or a certified cheque or money order made payable to the Town/Municipality/Regional Municipality of ___________________ as a deposit pursuant to the Municipal Elections Act. Dated at ______________ this _____ day of ______________, ______ . Returning Officer 498

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Part II Regulations Form 12

Section 51 Affidavit re Removal of Advertising Materials I, _______________________________________, solemnly swear (or affirm) that (name of candidate) 1. I was a candidate for the office of ________________________ of the ______________________ at the election held on the _______ day of ____________, ______. 2. I have removed or caused to be removed all advertising and election materials which were posted or displayed on my behalf. 3. I recognize that failure to remove advertising and election materials from public places is a violation of the Municipal Elections Act.

Sworn (or affirmed) at __________________ in the County of _______________________ this ________ day of ____________________, ______, before me (see

Section 146) Candidate (or Official Agent if authorized and the authorization is attached) 499

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Part II Regulations Form 14

Section 68 Format of Poll Book 1. The cover of the poll book shall bear the subject of the election, the polling district number, and the date of ordinary polling day. 2. Each of the first three pages of the poll book shall contain Form 2. 3. The fourth page of the poll book shall contain Form 16. 4. Form 24 shall be on the fifth page, then Forms [24A ], 25, 26, 27, 28, and 29 shall follow. 5. Then shall follow twelve pages of Form 30. 6. Then shall follow three pages of Form 31. 7. Then shall follow three pages of Form 31A. 8. Then shall follow three pages of Form 31B. 9.

Then shall follow three pages of Form 32. 10. Then shall follow eight pages of Form 33 or 34 for each matter for which a poll was granted. 11. Then shall follow eight pages of Form 35 for each matter for which a poll was granted and the back cover. This format may be varied by altering the number of copies of forms required to be included to suit the circumstances of the election. Additional or loose copies of some forms also may be used; these should be added to the poll book at the end of voting. 500

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Part II Regulations Form 17

Section 70 Appointment of Official Agent I, the undersigned, a candidate for the office of ____________________________, (place a check mark next to the applicable statement) _____ appoint ______________ of ________________ as my official agent with (name) (address) authority to represent me in the manner provided by the Municipal Elections Act at the election being held on ________________, ______. OR _____ declare that I will act personally as official agent in the manner provided by the Municipal Elections Act at the election being held on ___________, _____.

Oath or Affirmation of Official Agent I, the undersigned, appointed by the foregoing candidate to be his/her official agent at the election to be held in the of ______________________ on the __________ day of ______________, _____, swear (or solemnly affirm) that I will not attempt in any way unlawfully to ascertain the candidate or candidates for whom a voter has voted and will not in any way aid in the unlawful discovery of the same, and that I will keep secret all knowledge which may come to me of the candidates for whom any voter has voted.

Sworn (or affirmed) at _________________ in the County of ______________________ this _________ day of _________________, ______, before me See

Section 146 Official Agent Signature of Candidate (A Translation of this form is available in French.) 501

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Part II Regulations Form 20

Section 73 Transfer Certificate (Polling District) I certify that the voter named below is entitled under

Section 73 of the Municipal Elections Act to a transfer certificate permitting him/her to transfer his/her vote from Polling Station Number _______ in Polling District Number __________ to Polling Station Number __________ in Polling District Number ____________, and I grant this certificate so authorizing him/her to vote for the election of ________________________________________________________________. (specify mayor, councillor(s), regional/district school board member(s), CSAP , plebiscite) Name of Elector Address Dated this ________ day of ____________________, _______ Returning Officer or Assistant Returning Officer Note: Complete in Triplicate 502

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Part II Regulations 503

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Part II Regulations Form 31

Section 98 Oath or Affirmation of Elector Not on List of Electors I swear (or solemnly affirm) that 1. On this date I actually reside in Polling Division Number ________ of the Town/Municipality/Regional Municipality of ________________________. 2. I have been ordinarily resident in the Town/Municipality/Regional Municipality of _____________________ (or in an area annexed to the Town/ Municipality/ Regional Municipality of ____________________________) for a period of three months immediately preceding ordinary polling day in this election. 3.

I have not voted before in this election at any other polling place and will not do so or attempt to do so. 4. I am a Canadian citizen and of the full age of eighteen years, or will be on ordinary polling day. 5. I am not the returning officer, a person serving a sentence in a penal or reform institution, or a person convicted of bribery under the Municipal Elections Act in the six years preceding ordinary polling day.

Consents to Name Address of Elector Signature of Elector being added to Voters List* (* write yes or no) Sworn (or affirmed) at _____________________ in the County of __________________________ this ____ day of _____________, ______, before me _________________________________________ Deputy Returning Officer The Voters List may be used in future municipal, provincial or federal elections. 504

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Part II Regulations Form 31A

Section 98 Oath or Affirmation of Elector Not on List of Electors For Use When Elector Can Vote Only for Regional/District School Board I swear (or solemnly affirm) that 1. On this date I actually reside in Polling Division Number ________ of the Town/Municipality/Regional Municipality of _________________________. 2. I have been ordinarily resident in the school region/district in which my polling division is located for a period of three months immediately preceding ordinary polling day in this election. 3.

I have not voted before in this election at any other polling place and will not do so or attempt to do so. 4. I am a Canadian citizen and of the full age of eighteen years, or will be on ordinary polling day. 5.

I am not the returning officer, a person serving a sentence in a penal or reform institution, or a person convicted of bribery under the Municipal Elections Act in the six years preceding ordinary polling day. (Note: Electors to sign below, and if elector wishes to vote for African Nova Scotian member, also to sign “Statement of an African Nova Scotian Elector”.) Address of Elector Signature of Elector Sworn (or affirmed) at in the County of this ____ day of _____________, ______, before me Deputy Returning Officer 505

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Part II Regulations Form 31B

Section 98 Oath or Affirmation of Elector Not on List of Electors For Use When Elector Can Vote Only for Conseil Scolaire Acadien Provincial I swear (or solemnly affirm) that 1. On this date I actually reside in Polling Division Number ________ of the Town/Municipality/Regional Municipality of ________________________. 2. I have been ordinarily resident in the Province of Nova Scotia for a period of three months immediately preceding ordinary polling day in this election. 3. I have not voted before in this election at any other polling place and will not do so or attempt to do so. 4.

I am a Canadian citizen and of the full age of eighteen years, or will be on ordinary polling day. 5. I am not the returning officer, a person serving a sentence in a penal or reform institution, or a person convicted of bribery under the Municipal Elections Act in the six years preceding ordinary polling day. (Note: Electors to sign below and also to sign “Statement of a CSAP Elector”.) Address of Elector Signature of Elector Sworn (or affirmed) at in the County of this ____ day of _____________, ______, before me Deputy Returning Officer (A translation of this form is available in French.) 506

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Part II Regulations Form 33 Sections 106, 111, 119 Statement of Poll (One Candidate or Matter) (For use when only one candidate to be elected or one matter to be determined) Municipality: Polling District: Polling Station No.: Election for: Date: 1. Number of blank ballots received from Returning Officer 2. Add number of ballots from advance poll (if any) 3. TOTAL BALLOTS TO BE ACCOUNTED FOR * 4. Number of ballots taken from polling station (if any) 5. Number of unused ballots 6. Number of cancelled ballots (ones not placed in ballot box) 7. Number of rejected ballots (rejected during counting) 8.

Number of ballots counted for ___________________ 9. Number of ballots counted for ___________________ 10. Number of ballots counted for ___________________ 11. Number of ballots counted for ___________________ 12. Number of ballots counted for ___________________ 13. Number of ballots counted for ___________________ 14. Number of ballots counted for ___________________ 15. Number of ballots counted for ___________________ 16. Number of ballots counted for ___________________ 17. Number of ballots counted for ___________________ 507

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Part II Regulations 18. Number of ballots missing (if any) 19. TOTAL BALLOTS ACCOUNTED FOR * *Note: Lines 3 and 19 must balance Number of names on the final list of electors used at the polling station plus electors sworn in at the polling station and added to the list (if any) Dated at _________________ this ________ day of _______________, ______ Approved: We certify that the above statement is correct Deputy Returning Officer Poll Clerk 508

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Part II Regulations Form 34 Sections 106, 111, 119 Statement of Poll (More Than One Candidate or Matter) (For use where more than one candidate is to be elected for the office or more than one matter is to be determined from the ballot) Municipality: Polling District: Polling Station No.: Election for: Date: 1. Number of blank ballots received from Returning Officer 2. Add number of ballots from advance poll (if any) 3. TOTAL BALLOTS TO BE ACCOUNTED FOR * 4. Number of ballots taken from polling station (if any) 5. Number of unused ballots 6. Number of cancelled ballots (ones not placed in ballot box) 7.

Number of rejected ballots (rejected during counting) 8. Number of ballot papers counted and accepted 9. Number of ballot papers missing (if any) 10. TOTAL BALLOTS ACCOUNTED FOR * *Note: Lines 3 and 10 must balance Ballots Cast For Name of Candidate (or Plebiscite matter) Number of Ballots Counted Number of names on the final list of electors used at the polling station, plus electors sworn in at the polling station and added to the list (if any) 509

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Part II Regulations Dated at __________________ this ________ day of ______________, ______ Approved: We certify that the above statement is correct Deputy Returning Officer Poll Clerk 510

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Part II Regulations Form 34A

Section 123A Statement of Poll to be Completed when School Board Ballots to be Transferred for Counting (For use [when] either one or more candidate to be elected.) Municipality: Polling District: Polling Station No.: Election for: Date: 1. Number of blank ballots received from Returning Officer 2. Add number of ballots from Advance Poll (if any) 3. TOTAL BALLOTS TO BE ACCOUNTED FOR * 4. Number of ballots taken from the polling station (if any) 5. Number of ballots missing (if any) 6. Number of unused ballots 7. Number of cancelled ballots (ones not placed in the ballot box) 8.

Number of ballots cast at polling station for this office (ones placed in the ballot box) Ë 9. TOTAL BALLOTS ACCOUNTED FOR * *Note: Lines 3 and 9 must balance 10. TOTAL BALLOTS BEING TRANSFERRED Ë ËNote: Lines 8 and 10 must balance Dated at _______________ , this ____ day of ______________ , _______ Approved: We certify that the above statement is correct Deputy Returning Officer Poll Clerk 511

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Part II Regulations Form 38

Section 128 Recapitulation Sheet Note: “Rejected Ballots” are only those cast but not counted. Do not enter cancelled ballot papers on this sheet.

POLLING STATION (Result of voting must be given for each station) Number of Names on Final List of Electors BALLOTS CAST FOR CANDIDATES Names of Candidates Number of Polling Division Name or Number of Polling District (if any) and name or location of Polling Station plus Electors added to list Rejected Ballots I certify that the foregoing statement is the correct result of the polling at the election held on ______________ day of __________________________, _____ Dated at _________________ this ______ day of ___________________, _____ Returning Officer Sheet Number 512

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Part II Regulations Form 39

Section 147

Section 50, Education Act Council Member’s/School Board Member’s Oath of Allegiance and of Office I, ____________________________, swear (or solemnly affirm) that I will be faithful and bear true allegiance to Her Majesty Queen Elizabeth the Second, Her heirs and successors according to law; (the name of and reference to the sovereign to be changed as occasion requires.) And that I am duly qualified as required by law for the office of ________________ of the ________________ of ________________; And that I will truly, faithfully and impartially execute the duties of the office to which I have been elected to the best of my knowledge and ability; And that I have not received and will not receive any payment or reward or promise thereof for the exercise of any partiality or other undue execution of the duties of my office.

Sworn (or affirmed) at ______________ in the County of ___________________ this _____ day of ____________________, _______, before me __________________________________ Judge, Justice of the Peace (or for council members, also Mayor, Warden or Clerk) 513

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Part II Regulations Form 42

Section 13(3), Education Act Statement of a Conseil Scolaire Acadian [Acadien] Provincial Elector Under the Education Act, only an “entitled person” may vote for a member of the Conseil scolaire acadian [acadien] provincial. Under the Education Act, an “entitled person” is defined to mean a person who is a Canadian citizen AND (

a) whose first language learned and still understood is French; OR (

b) who received his or her primary school instruction in Canada in a French- first-language program; OR (

c) who is the parent of a child who has received or is receiving primary or secondary school instruction in Canada in a French-first-language program (note that the definition of “parent” in respect to “entitled persons” does not include a guardian or person acting in loco parentis to a child). I state that I am an “entitled person” within the meaning of this definition. Name (please print) Signature (A translation of this form is available in French.) Form 43

Section 42A, Education Act Statement of an African Nova Scotian Elector Under the Education Act, only an “African Nova Scotian elector” may vote for an African Nova Scotian member of a school board. Under the Education Act, an “African Nova Scotian elector” is defined to mean a person who is qualified to vote in an election of a school board AND (

a) who is an African Nova Scotian or a black person, OR (

b) who is the parent of an African Nova Scotian or a black person. I state that I am an “African Nova Scotian elector” within the meaning of this definition. Name (please print) Signature 514

N.S. Reg. 130/2000 ROYAL GAZETTE

Part II Regulations Form 44 Statement of Poll

Section 123A Consolidated Count of School Board Ballots (One Member to be Elected from the School Board Electoral District) (For use when the ballots from polls with fewer than 10 votes for a school board office are counted by a counting officer) School Board School Board Electoral District Number of Polls to be Counted (# of envelopes to be opened and counted) 1. Total Number of Ballots to be Counted (from endorsements on each envelope from each polling station) * 2. Number of Rejected Ballot Papers 3. Number of Ballot Papers Counted and Accepted 4. Number of Ballot Papers Missing (if any) (#1 minus #3) 5.

Additional Ballot Papers (if any) (#3 minus #1) 6. Total Ballots to be Accounted for * [Note: Lines 1 and 6 must balance.] 7. Number of Ballots counted for Number of Ballots counted for Number of Ballots counted for Number of Ballots counted for Number of Ballots counted for 8. TOTAL BALLOTS ACCOUNTED FOR * Note: Lines 6 and 8 must balance. Dated at _________________, this _______ day of _____________, ______. Approved I certify that the above statement is correct Counting Officer 515

N.S. Reg. 130/2000 ROYAL GAZETTE

Part II Regulations Form 45 Statement of Poll

Section 123A Consolidated Count of School Board Ballots (More than One Member to be Elected from the School Board Electoral District) (For use when the ballots from polls with fewer than 10 votes for a school board office are counted by a counting officer) School Board School Board Electoral District Number of Polls to be Counted (# of envelopes to be opened and counted) 1. Total Number of Ballots to be Counted (from endorsements on each envelope from each polling station) * 2. Number of Rejected Ballot Papers 3. Number of Ballot Papers Counted and Accepted 4.

Number of Ballot Papers Missing (if any) (#1 minus #3) 5. Additional Ballot Papers (if any) (#3 minus #1) 6. Total Ballots to be Accounted for * Note: Lines 1 and 6 must balance. 7 Names of Candidates Number of Ballots (V otes) 8. TOTAL BALLOTS ACCOUNTED FOR * Note: Lines 6 and 8 must balance. Dated at _________________, this _______ day of _____________, ______. Approved I certify that the above statement is correct Counting Officer 516