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AR 69/2018 ELECTION ACT FORMS

(no amdt)

ALBERTA REGULATION 69/2018

Election Act

ELECTION ACT FORMS REGULATION

Election Act forms

1(1)  The forms in the Schedule to this Regulation are prescribed for the purposes of the sections of the Election Act indicated on the forms.

(2)  The forms required to be prescribed under the Election Act that are not set out in the Schedule are to be prescribed by the Chief Electoral Officer.

Repeal

2   The Election Act Forms Regulation (AR 141/2011) is repealed.


 

Schedule

Form 1
(Section 39)

Writ of Election

AR 121-98 pg 3(1

Canada

Province of Alberta

Elizabeth The Second, by the Grace of God, of the United Kingdom, Canada and her other Realms and Territories, Queen, Head of the Commonwealth, Defender of the Faith.

To                  , Returning Officer of the Electoral
Division of                                                                                           .

Greeting:

We command you that, notice of the time and place of election being given, you do cause an election to be held according to law, to elect a Member to serve in the Legislative Assembly of Our Province of Alberta for the Electoral Division of         with nomination day for the election to be the     day of       , 20__, and that in the event that voting is necessary you do cause a poll to be taken on the      day of        , 20   , and you do certify the name of the member so elected to the Chief Electoral Officer on the      day of         , 20    , being the date fixed for the return of the writ.

Dated at the City of Edmonton in the Province of Alberta, this            day of             , 20     .

                                                            Endorsement                             

By Order:                                      This writ received on the
                                                      day of       , 20                                   

                                                                                                        

 Chief Electoral Officer                          Returning Officer


 

Form 2
(Sections 4(3)(c), 46, 71,
73, 75.1, 76, 77.1, 113)

Appointment and Oath of Election Officer
(other than a returning officer, election
clerk, enumerator or administrative assistant)

I,        (print name)        of         (print address)           , appointed as      (position)     in the Electoral Division of                           , Polling Subdivision number     (complete if applicable)   , in the Province of Alberta, swear (or affirm) that I am not a member of the Parliament of Canada, a member of the Legislative Assembly,
a councillor under the Municipal Government Act, a trustee of a board of trustees under the School Act, a candidate, an official agent, or a judge of a federal or provincial court, and that I have
not within the immediately preceding 10 years been convicted of an indictable offence where the penalty that may be imposed for that offence is greater than 2 years’ imprisonment and that I will act impartially and diligently in carrying out my duties under the Election Act.

Sworn (or affirmed) before me    )                                                              
at the                   of                    ,    )              (signature of election officer)

in the Province of Alberta, this    )     
        day of                      , 20     .     )      ___  Initial here if contact information
                                                               can be shared with other election     

                                                       )         officers for the purpose of possible
(signature of authorized person)   )             future employment.

 

Print name:                                      
Authority to administer oath:
                                                    

A person who takes a false oath under the Election Act commits an offence and is liable to a fine of not more than $10 000 or to imprisonment for not more than one year or to both a fine and imprisonment.

 


 

Form 3
(Sections 9, 12, 46, 47, 47.1)

Appointment and Oath of Returning
Officer, Election Clerk and
Administrative Assistant

I,        (print name)        of         (print address)           , appointed as      (position)     in the Electoral Division of                           , in the Province of Alberta, swear (or affirm) that I am not a member of the Parliament of Canada, a member of the Legislative Assembly, a councillor under the Municipal Government Act, a trustee of a board of trustees under the School Act, a candidate, an official agent, or a judge of a federal or provincial court, and that I have not within the immediately preceding 10 years been convicted of an indictable offence where the penalty that may be imposed for that offence is greater than 2 years’ imprisonment and if appointed as a returning officer or an election clerk, I also swear or affirm that I am an elector.

I understand that, while I am appointed as a returning officer, election clerk or administrative assistant, I may not engage in political activity on behalf of any political party, candidate or constituency association, and that I may not make a contribution under the Election Finances and Contributions Disclosure Act.

I will act impartially and diligently in carrying out my duties under the Election Act.

Sworn (or affirmed) before me    )                                                              
at the                   of                    ,    )              (signature of election officer)

in the Province of Alberta, this    )     
        day of                      , 20     .     )     
                                                       

                                                       )     
(signature of authorized person)   )     

 

Print name:                                      
Authority to administer oath:
                                                    

A person who takes a false oath under the Election Act commits an offence and is liable to a fine of not more than $10 000 or to imprisonment for not more than one year or to both a fine and imprisonment.

 


 

Form 4
(Sections 24 and 28)

Appointment and Oath of Enumerator

I,        (print name)        of         (print address)           , appointed as      (enumerator)     in the Electoral Division of                           , Polling Subdivision number     (complete if applicable)   , in the Province of Alberta, swear (or affirm) that I am not a member of the Parliament of Canada, a member of the Legislative Assembly,
a candidate, an official agent, or a judge of a federal or provincial court, and that I have not within the immediately preceding 10 years been convicted of an indictable offence where the penalty that may be imposed for that offence is greater than 2 years’ imprisonment and that I will act impartially and diligently in carrying out my duties under the Election Act.

Sworn (or affirmed) before me    )                                                              
at the                   of                    ,    )                    (signature of enumerator)

in the Province of Alberta, this    )     
        day of                      , 20     .     )      ___  Initial here if contact information
                                                               can be shared with other election     

                                                       )         officers for the purpose of possible
(signature of authorized person)   )             future employment.

 

Print name:                                      
Authority to administer oath:
                                                    

A person who takes a false oath under the Election Act commits an offence and is liable to a fine of not more than $10 000 or to imprisonment for not more than one year or to both a fine and imprisonment.

 


 

Form 5
(Sections 82 and 83)

Form of Ballot

FRONT OF BALLOT

     Stub                                  Ballot

 

CANDIDATE’S NAME
NAME OF PARTY OR INDEPENDENT

CANDIDATE’S NAME
NAME OF PARTY OR INDEPENDENT

CANDIDATE’S NAME
NAME OF PARTY OR INDEPENDENT

CANDIDATE’S NAME
NAME OF PARTY OR INDEPENDENT

                                               BACK OF BALLOT

0 0 0 0 0 0 0 0

Stub

INITIALS OF
ELECTION
OFFICER

             

Electoral Division of
                          
Year               

               (SECOND FOLD) 

       Ballot

(FIRST FOLD)

 


 

Form 6
(Sections 185 and 186)

Form of Petition Controverted Election

AR 121-98 pg 3(1

                                                                                      Clerk’s stamp:

COURT FILE NUMBER

COURT OF QUEEN’S BENCH OF ALBERTA

JUDICIAL CENTRE

PETITIONER               (Print name of petitioner)

RESPONDENT           (Print name of respondent)

DOCUMENT                              PETITION —                           

                                                      CONTROVERTED ELECTION

ADDRESS FOR SERVICE AND

CONTACT INFORMATION OF

PARTY FILING THIS DOCUMENT

The petition of    (print name of petitioner)    of   (print residential address)     shows that

●    an election was held on the                      day of            20   , for the Electoral Division of                     at which the Respondent was a candidate and has been returned as the person elected at that election,

●    the petitioner was a qualified elector at that election (or the petitioner was a defeated candidate at that election), and

●    the petition is made by reason of undue return or undue election of the Respondent as a member of the Legislative Assembly, in particular (state here the facts and grounds on which the petitioner relies).

The petitioner prays that it may be declared that the

election of the Respondent is void and that it be set aside.

Dated this               day of                   , 20       .

                                                 
     (signature of petitioner)