地方选区监察点票代理人委任通知书Noticeof-选举事务处.PDFVIP

地方選區監察點票代理人委任通知書 NOTICE OF APPOINTMENT OF COUNTING AGENTS FOR A GEOGRAPHICAL CONSTITUENCY 《選舉管理委員會 （選舉程序）（立法會）規例》（第 541D 章）第 66 及 96 條 Sections 66 and 96 of the Electoral Affairs Commission (Electoral Procedure) (Legislative Council) Regulation (Cap. 541D) 2018 年立法會補選 2018 LEGISLATIVE COUNCIL BY-ELECTION （地方選區名稱） (Name of Geographical Constituency) 補選日期 ：2018 年3 月11 日 Date of By-election: 11 March 2018 ［附註： 在填寫此通知書前，請參閱 《填寫地方選區監察點票代理人委任通知書說明》 （“說明”）。﹞ [Note: Before completing this notice, please read the “Notes on Completion of Notice of Appointment of Counting Agents for a Geographical Constituency ” ( “Note(s) ”) .] 第一部分 委任 （由候選人或選舉代理人填寫） PART I APPOINTMENT (To be completed by candidate or election agent) 候選人姓名 （正楷）： Name of Candidate (in BLOCK LETTERS) (姓Surname) (名Other name) 點票站／選票分流站名稱： Name of Counting Station(s)/ Ballot Paper Sorting Station(s) 1. *我為上述*候選人／候選人的選舉代理人，現委任下列人士於上述補選中擔任*我／上述候選人在上 述點票站／選票分流站之監察點票代理人 （見說明第 2 項）－ *I being the *above-named candidate/election agent of the above-named candidate, hereby appoint the following person(s) to act as *my/the candidate ’s counting agent(s) for the above-named counting station(s)/ballot paper sorting station(s) at the above-named by-election (see Note 2) – (a) 中文姓名（正楷）： Name in Chinese 英文姓名（正楷）： Name in English (in BLOCK LETTERS) (姓Surname) (名Other name) 香港身分證號碼： 聯絡電話： Hong Kong Identity Card Number Contact Telephone Number