Professional Documents
Culture Documents
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(Region)
INSTRUCTIONS:
PREPARE IN FOUR (4) COPIES. Deliver one copy to the member of the Board; voter or watcher making
challenge or protest; one copy to the individual against whom the challenge or protest is made; and one
copy to the watcher who will be requesting for a copy hereof. The Board shall retain the third copy.
The Board, after considering the evidence presented to it, DECIDED as follows:
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IN WITNESS WHEREOF, we hereby sign the Certificate this _____day of ______________, 2013.
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Chairman
(Signature over Printed Name)
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Poll Clerk Third Member
(Signature over Printed Name) (Signature over Printed Name)