e-6.01 reg 2 - the election forms (chief electoral officer) … · 2020-02-25 · 3 election forms...

1ELECTION FORMS

(CHIEF ELECTORAL OFFICER) E-6.01 REG 2

The Election Forms (Chief

Electoral Officer) Regulations

Repealedby Saskatchewan Regulations 6/2020

(effective January 31, 2020).

FormerlyChapter E-6.01 Reg 2 (effective December 19, 1997) amended by Saskatchewan Regulation 47/2001, 6/2006 and 85/2014.

NOTE:This consolidation is not official. Amendments have been incorporated for convenience of reference and the original statutes and regulations should be consulted for all purposes of interpretation and application of the law. In order to preserve the integrity of the original statutes and regulations, errors that may have appeared are reproduced in this consolidation.

http://www.qp.gov.sk.ca/documents/gazette/part2/2001/g2200128.pdf

http://www.qp.gov.sk.ca/documents/gazette/part2/2006/G2200607.pdf

http://www.qp.gov.sk.ca/documents/gazette/part2/2014/G2201444.pdf

ELECTION FORMS(CHIEF ELECTORAL OFFICER)

2

E-6.01 REG 2 Table of Contents

1 Title2 Interpretation3 Forms prescribed4 Coming into force

Appendix

FormsForm E Petition for Registration of a Political Party

Form F Writ of Election

Form G Oath or Declaration of Returning Officer

Form H Appointment of Election Clerk

Form I Oath or Declaration of Election Clerk

Form J Affidavit of Printer

Form K Affidavit to be Made by Returning Officer after Sending his or her Return to the Chief Electoral Officer

Form L Notice of Request for Recount or Addition

Form M Certificate of Returning Officer (Recount or Addition)

Form N Appointment of Enumerator by Returning Officer

Form O Oath or Declaration of Enumerator

Form P Appointment of Deputy Returning Officer

Form Q Oath or Declaration of Deputy Returning Officer

Form R Appointment of Supervisory Deputy Returning Officer

Form S Oath or Declaration of Supervisory Deputy Returning Officer

Form T Appointment of Poll Clerk

Form U Oath or Declaration of Poll Clerk

Form V Oath or Declaration of Interpreter

Form W Oath or Declaration of Secrecy

Form X Oath or Declaration of Inability to Mark Ballot Paper

Form Y Oath or Declaration of Friend of Voter

Form Z Oath or Declaration of Poll Clerk after Closing of the Polling Place for Voting

Form AA Oath or Declaration of Deputy Returning Officer after Closing of the Polling Place for Voting

Form BB Receipt for Ballot Box

Form CC Oath or Declaration of Messenger who Delivers the Ballot Box to the Returning Officer

Form DD Declaration of Voter

Form EE Ballot Paper Account and Poll Statement

Form FF Ballot Template

Form GG Notice to Voters – Northern Constituencies

Form HH Directions for the Guidance of VotersForm II Notice as to Secrecy of VotingForm JJ Statement by Deputy Returning Officer

Respecting Voters who Made the Declaration on Election Day

Form KK Voters who Voted at Advance Poll or Mobile Poll

Form LL Voters’ ListForm MM Certificate of Returning OfficerForm NN Certificate of Revision

Form OO Absentee Voter Application

Form PP Certificate Envelope

Form QQ Outer Envelope to the Returning Officer

Form RR Statement of Ballots Mailed or Delivered to the Returning Officer

Form SS Nomination Paper

Form TT Certificate Respecting Nomination Paper and Deposit

Form UU Withdrawal of Candidate

Form VV Candidate’s Return of Election Expenses

Form WW Oath or Declaration of Business Manager of a Candidate

Form XX Candidate’s Oath or Declaration as to Expenses

Form YY Summary of Candidate Election Expenses

Form ZZ Registered Political Party’s Return of Election Expenses

Form AAA Oath or Declaration of a Chief Official Agent of a Registered Political Party

Form BBB Registered Political Party’s Fiscal Period Return

Form CCC Statement Respecting Election Programs, Advertisements and Announcements

Form DDD Certificate of the Returning Officer (Number of Voters on Official Voters’ List)

Form EEE Poll Book

Form FFF Oath or Declaration of a Chief Official Agent of a Registered Political Party

Form GGG

Form HHH Application to Chief Electoral Officer for Registration of a Political Party

Form III Homebound Voter Application and Declaration

Form JJJ Certificate Envelope

Form KKK Statement of Homebound Voters’ Ballots Delivered to the Returning Officer

Form LLL Poll Book (Homebound Voters)

Form MMM Application for Revision

Form NNN Application to Access Information in Register of Voters

Form OOO Enumeration/Registration at a Poll

3ELECTION FORMS


CHAPTER E-6.01 REG 2The Election Act, 1996

Title1 These regulations may be cited as The Election Forms (Chief Electoral Officer) Regulations.

Interpretation2 In these regulations:

(a) “Act” means The Election Act, 1996;

(b) “Form” means a form as set out in the Schedule to these regulations.2 Jan 98 cE-6.01 Reg 2 s2.

Forms prescribed3 For the purposes of the Act: [note that Forms A to D were prescribed in The Election Regulations, being chapter E-6.01 Reg 1 of The Revised Regulations of Saskatchewan]

(a) Form E is prescribed as the form for registering a political party;

(b) Form F is prescribed as the form for the Writ of Election;

(c) Form G is prescribed as the form for the oath or declaration of a returning officer;

(d) Form H is prescribed as the form for the appointment of an election clerk;

(e) Form I is prescribed as the form for the oath or declaration of an election clerk;

(f) Form J is prescribed as the form for the affidavit of a printer;

(g) Form K is prescribed as the form for the affidavit made by a returning officer after sending his or her return to the chief electoral officer;

(h) Form L is prescribed as the form for a notice of request for a recount or addition;

(i) Form M is prescribed as the form for a certificate of a returning officer respecting a recount or addition;

(j) Form N is prescribed as the form for appointment of an enumerator by a returning officer;

(k) Form O is prescribed as the form for the oath or declaration of an enumerator;

(l) Form P is prescribed as the form for appointment of a deputy returning officer;


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E-6.01 REG 2

(m) Form Q is prescribed as the form for the oath or declaration of a deputy returning officer;

(n) Form R is prescribed as the form for appointment of a supervisory deputy returning officer;

(o) Form S is prescribed as the form for the oath or declaration of a supervisory deputy returning officer;

(p) Form T is prescribed as the form for appointment of a poll clerk;

(q) Form U is prescribed as the form for the oath or declaration of a poll clerk;

(r) Form V is prescribed as the form for the oath or declaration of an interpreter;

(s) Form W is prescribed as the oath or declaration of secrecy required for the purposes of section 14 of the Act;

(t) Form X is prescribed as the oath or declaration of inability to mark a ballot paper for the purposes of sections 77 and 78 of the Act;

(u) Form Y is an oath or declaration of a friend of a voter for the purposes of sections 77 and 78 of the Act;

(v) Form Z is prescribed as the oath or declaration of a poll clerk after the closing of the polling place for voting;

(w) Form AA is prescribed as the oath or declaration of a deputy returning officer after the closing of the polling place for voting;

(x) Form BB is prescribed as the form for the receipt for a ballot box to be made by a deputy returning officer for the purposes of section 93, 100, 108, 116, 126, 135 and 143 of the Act;

(y) Form CC is prescribed as the oath or declaration of a messenger who delivers a ballot box to a returning officer;

(z) Form DD is prescribed as the form for a declaration of a voter;

(aa) Form EE is prescribed as the form for the ballot paper account and poll statement;

(bb) Form FF is prescribed as the form for the ballot template;

(cc) Form GG is prescribed as the form for the notice to voters in northern constituencies, as defined in section 136 of the Act;

(dd) Form HH is prescribed as the form for the directions for the guidance of voters;

(ee) Form II is prescribed as the form of notice as to the secrecy of voting;

(ff) Form JJ is prescribed as the form for the statement by a deputy returning officer respecting voters who made the voter’s declaration on election day;

(gg) Form KK is prescribed and the form for the list of voters who voted at an advance poll or mobile poll;

5ELECTION FORMS


(hh) Form LL is prescribed as the form for the voters’ list;

(ii) Form MM is prescribed as the form for the certificate of an enumerator;

(jj) Form NN is prescribed as the form prescribed as the certificate of revision of a voters’ list;

(kk) Form OO is prescribed as the form for an application to be considered as an absentee voter and to vote pursuant to section 87 of the Act;

(ll) Form PP is prescribed as the form for the certificates to be completed with respect to absentee voters pursuant to section 88 of the Act;

(mm) Form QQ is prescribed as the form to be used on the outer envelope of an absentee voter pursuant to section 88 of the Act;

(nn) Form RR is prescribed as the form for the statement of absentee voters ballots mailed or delivered to a returning officer;

(oo) Form SS is prescribed as the form for a nomination paper;

(pp) Form TT is prescribed as the certificate of a returning officer respecting the filing of a nomination paper and deposit;

(qq) Form UU is prescribed as the form for a withdrawal of a candidate;

(rr) Form VV is prescribed as the form for the return of a candidate’s election expenses;

(ss) Form WW is prescribed as the form for the oath or declaration of a candidate’s business manager required pursuant to clause 261(1)(c) of the Act;

(tt) Form XX is prescribed as the form for the oath or declaration of a candidate respecting the candidate’s election expenses required pursuant to subsection 261(4) of the Act;

(uu) Form YY is prescribed as the form for the summary of a candidate’s election expenses;

(vv) Form ZZ is prescribed as the form of return to be made by a registered political party respecting is election expenses pursuant to section 251 of the Act;

(ww) Form AAA is prescribed as the form for the oath or declaration of the chief official agent of a registered political party respecting its election expenses and required pursuant to clause 251(1)(c) of the Act;

(xx) Form BBB is prescribed as the form for the annual return of a registered political party required pursuant to section 250 of the Act;

(yy) Form CCC is prescribed as the statement respecting election programs, advertisements and announcements required by a broadcaster or publisher of a newspaper, magazine or periodical pursuant to section 279 of the Act;

(zz) Form DDD is prescribed as the form for the certificate of the returning officer respecting the number of voters on the official voters’ list pursuant to section 252 of the Act;


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E-6.01 REG 2

(aaa) Form EEE is prescribed as the form of the poll book pursuant to section 5 of the Act;

(bbb) Form FFF is prescribed as form for the oath or declaration of the chief official agent of a registered political party pursuant to section 250 of the Act.

(ccc) Form GGG is prescribed as the form to be used for the purposes of section 5 of the Act;

(ddd) Form HHH is prescribed as the form to be used for the purposes of applying to the Chief Electoral Officer for registration of a political party;

(eee) Form III is prescribed as the form to be used for the purposes of an application to be considered as a homebound voter pursuant to subsection 89.2(1) of the Act;

(fff) Form JJJ is prescribed as the form to be used for the certificate to be completed with respect to absentee voters pursuant to section 89.3 of the Act;

(ggg) Form KKK is prescribed as the form for the statement of homebound voters’ ballots mailed or delivered to a returning officer;

(hhh) Form LLL is prescribed as the form of the poll book record to be used to contain the names of persons who have voted as homebound voters;

(iii) Form MMM is prescribed as the form to be used by an applicant for revision of the preliminary voters’ list pursuant to section 29.1 of the Act;

(jjj) Form NNN is prescribed as the form to be used for the purposes of an application to access information in the register of voters pursuant to section 18.6 of the Act;

(kkk) Form OOO is prescribed as the form to be used to record collected voter data during an enumeration pursuant to section 22 of the Act.

2 Jan 98 cE-6.01 Reg 2 s3; 17 Feb 2006 SR6/2006 s3; 31 Oct 2014 SR 85/2014 s3.

Coming into Force4 These regulations come into force on the day on which they are filed with the Registrar of Regulations.

2 Jan 98 cE-6.01 Reg 2 s4.

7ELECTION FORMS


Appendix

FORM E[Section 224 of the Act]

Petition for Registration of a Political Party

We, the undersigned residents of Saskatchewan:

1. petition to the Chief Electoral Officer of Saskatchewan in support of an application for the registration of_____________________________________________________ , a political party, pursuant to the provisions ofsubsection 224(2) of The Election Act, 1996.

2. severally declare, each for himself or herself, that:

(a) we are Canadian citizens or British subjects other than Canadian citizens who were qualified asvoters on June 23, 1971;

(b) we are of the full age of 18 years;

(c) we have ordinarily resided in Saskatchewan for at least six months immediately preceding the daywe signed this petition;

(d) we are not disqualified from voting pursuant to section 17 of The Election Act, 1996;

(e) we reside in the constituency indicated beside our signatures; and

(f) we have each signed this petition only once.

Name Land Location – Rural or Post Office SignatureDate of Voter Street and Number – Cities and Towns Address Constituency of Voter

NOTE: In order for this petition to be valid it must be signed by not fewer than 2,500 voters, 1,000 ofwhom must reside in at least 10 different constituencies, with a minimum of 100 voters in each ofthose constituencies.

2 Jan 98 cE-6.01 Reg 2.


8

E-6.01 REG 2

FORM F[Sections 31, 32 and 33 of the Act]

Writ of ElectionCanada:Province of Saskatchewan.

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 _____________________________________________ of ___________________________________________________in the Province of Saskatchewan, greeting:

We command you that you do cause:

(a) an election to be held according to law of a member to serve in the Legislative Assembly of Saskatchewan forthe constituency of ________________________________________________________________________________;

(b) the nomination of candidates at the election to be held on ____________________________________________the ________________ day of ___________ next;

(c) the voting of voters to be held, if required, on _______________________________________________________the _________________ day of ______________________ ;

(d) if voting of voters is required, an advance poll to be held on the following days in the afternoon during thehours mentioned:

____________________ the _______ day of _______________ , _______ , from ____ o’clock to ____ o’clock;

____________________ the _______ day of ______________ , _______ , from ____ o’clock to ____ o’clock;




(e) the number of votes cast for the several candidates to be added up on _________________________________the _____________ day of _____________________ ;

(f) a return to the writ to be made on _________________________ the ___________ day of _________________.

In testimony whereof, we have caused these our letters to be made patent and the Great Seal of Saskatchewan tobe affixed.

Witness our trusty and well beloved, the Honourable _____________________________________________________,Lieutenant Governor of the Province of Saskatchewan at the City of Regina this ____________________________day of _____________________________________ in the _________________ year of our reign and the year of ourLord ___________________________ .

By order,(Seal)

______________________________________________________Signature of Chief Electoral Officer

Endorsement

Received this writ on ___________________ , being the _______ day of ______________ , ___________ .

______________________________________________________Signature of Returning Officer

2 Jan 98 cE-6.01 Reg 2.

9ELECTION FORMS


FORM G[Sections 9 and 12 of the Act]

Oath or Declaration of Returning Officer

I, ___________________________________________________________________________ , returning officer for the

constituency of _____________________________________________________________________________________ ,swear (or solemnly affirm):

1. That I am legally qualified to act as returning officer for this constituency, and that I will act faithfully inthat capacity, without partiality, fear, favour or affection;

2. That I will not attempt to ascertain and will by every means in my power prevent any other person fromascertaining how any person is about to vote or has voted at this election;

3. That I will not communicate to any person any information of any kind that may enable or assist anyperson to ascertain the candidate for whom any person has voted;

4. That I will in all respects maintain and aid in maintaining the absolute secrecy of the voting.

(So help me God.)(if sworn)

Sworn (or solemnly affirmed) before me at the _____________of _______________________ in the Province of Saskatchewan Signature of Returning Officerthis ___________ day of________________________ , ________ .

_________________________________________________________A Commissioner, etc. (or as the case may be)

}

2 Jan 98 cE-6.01 Reg 2.


10

E-6.01 REG 2

FORM H[Section 12 of the Act]

Appointment of Election Clerk

, :oTnoitapuccO emaN

of Residential Address

In my capacity of Chief Electoral Officer of Saskatchewan

I appoint you to be Election Clerk, to act in that capacity at the approaching election for the said

constituency of .

Given under my hand this day of , .

Signature of Chief Electoral Officer

31 Oct 2014 SR 85/2014 s5.

FORM I[Section 12 of the Act]

Oath or Declaration of Election Clerk

I, _____________________________________________________________________ , appointed election clerk for the

constituency of ______________________________________________________________________________________ ,swear (or solemnly affirm) that I am legally qualified to act as election clerk and that I will act faithfully in thatcapacity and also in that of returning officer if required to act in that capacity without partiality, fear, favour oraffection.


Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Election Clerkthis ___________ day of _______________________ , ________ .


}

2 Jan 98 cE-6.01 Reg 2.

11ELECTION FORMS


FORM J[Sections 35, 96, 104 and 112 of the Act]

Affidavit of Printer

Constituency of ________________________________________________________________________________________

I, ___________________________________________________________________________ , swear (or solemnly affirm):

1 That _____________ sheets for ballot papers numbered as follows, namely _____________________________ ,were delivered to me by the returning officer of the above-mentioned constituency for the printing of thoseballot papers, which were printed for use at the election to be held on the ________________________ day of________________________ , ______________, and each of the sheets was cut into ______________________

ballot papers;

2 That the number of ballot papers properly printed and delivered to the returning officer in Form A was____________________ , and in Form B was _____________ , and that no other ballot papers have been

supplied to any other person;

3 That ____________ sheets numbered as follows, namely, _____________________________________________ ,were not required and have been returned to the returning officer in the condition in which they werereceived;

4 That ____________ sheets of ballot papers were spoiled in printing and that every piece of spoiled ballotpaper has been returned to the returning officer; and

5 That, the ballot papers having been printed, the cut-off portions of all the sheets out of which ballot paperswere cut have been arranged in numerical order according to the numbers printed and returned to thereturning officer for return to the Chief Electoral Officer.

Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Printerthis ___________ day of________________________ , ________ .


}

2 Jan 98 cE-6.01 Reg 2.


12

E-6.01 REG 2

FORM K[Section 172 of the Act]

Affidavit to be Made by Returning Officer after Sendinghis or her Return to the Chief Electoral Officer

I, _____________________________________________________________________________ , returning officer for the

constituency of _____________________________________________________________ , swear (or solemnly affirm):

1 That of the envelopes received by me as returning officer from the Chief Electoral Officer with respect tothe recent election for the constituency, I have not opened or permitted to be opened any of the envelopesexcept those authorized and directed to be opened by a returning officer pursuant to The Election Act, 1996;

2 That none of the other envelopes have been opened by any person since they were returned to me by theChief Electoral Officer (or in case of a recount add, except by the judge on a recount);

3 That I have not ascertained and have not attempted to ascertain from the ballot papers or other contents ofany of the envelopes how any person voted;

4 That I have this day sent to the Chief Electoral Officer my return with respect to the election.

So help me God.(if sworn)

Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Returning Officerthis ___________ day of________________________ , ________ .


}

2 Jan 98 cE-6.01 Reg 2.

13ELECTION FORMS


FORM L[Section 155 of the Act]

Notice of Request for Recount or Addition

To: __________________________________________________________________________________________________(insert full name)

Returning Officer for the constituency of ______________________________________________________________

Pursuant to The Election Act, 1996:

1 I _______________________________________________ , of _____________________________ , Saskatchewan,a candidate for the constituency of _______________________________________________________________at the election held on the ______________________ day of _________________________ , _____________ .

(or)

I ____________________________________________________ , of _______________________ , Saskatchewan,a duly appointed business manager of ____________________________________________________________ ,a candidate for the constituency of _______________________________________________________________at the election held on the _________________ day of _______________________________ , ____________ :

(a) request a recount or addition of the votes cast at the election; and(b) request that you issue a certificate as required by section 155 of The Election Act, 1996.

2 My address for service of all documents required to be served on me is ______________________________________________________________________________________________________________________________

(Note – The address for service must be a specific address; if the candidate has retained a solicitor to act for himor her, the name of the solicitor and his or her business address shall be set out in full.)

Dated at _____________________ , Saskatchewan, this ___________ day of __________________ ,_________ .

____________________________________________________Signature of Candidate or Business Manager

2 Jan 98 cE-6.01 Reg 2.


14

E-6.01 REG 2

17 Feb 2006 SR 6/2006 s4.

FORM M [Section 155 of the Act]

Certificate of Returning Officer (Recount or Addition)

Constituency of

Pursuant to the written request of

of , Saskatchewan, a candidate for the constituency

of , (or of

of , Saskatchewan, Business Manager of

a candidate for the constituency of ) at the election held on the

day of , 20____; and pursuant to section 155 of The Election Act, 1996,

I, the undersigned Returning Officer for the constituency of

certify as follows:

1. That the majority of the votes cast at the election according to my addition, in favour of

, the candidate declared by me to have been

elected, is ;

That the number of all unopened ballot envelopes is ;

That the number of all ballots rejected is ; and

That the number of all ballots objected to is .

[or in the case of a tied result]

2. That on the final count I have found two or more candidates having the same number of votes and

that casting a vote would entitle one of the candidates to be declared elected, therefore I have

declared the result to be a tie vote.

Dated at , Saskatchewan, this day of , 20 .

reciffO gninruteR fo erutangiS

15ELECTION FORMS


FORM N[Section 20 of the Act]

Appointment of Enumerator by Returning Officer

Constituency of _______________________________________________________________________________________

In my capacity of returning officer, I appoint ____________________________________________________________of _____________________________________________________________ , to act as enumerator for Polling DivisionNo. (or in the case of a personal care facility insert name of facility) for the election now pending.

Dated this_______________ day of ______________________ , ____________ .

_____________________________________________________Signature of Returning Officer

2 Jan 1998 cE-6.01 Reg 2.

FORM O[Section 20 of the Act]

Oath or Declaration of Enumerator

I, the undersigned,____________________________________ , appointed enumerator for Polling Division No. (or

in the case of a personal care facility insert name of facility) of the constituency of __________________________in the Province of Saskatchewan, do swear (or solemnly affirm) that I will act faithfully in the capacity ofenumerator without partiality, fear, favour or affection.


Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Enumeratorthis ___________ day of________________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.


16

E-6.01 REG 2

FORM P[Section 10 of the Act]

Appointment of Deputy Returning Officer

To ___________________________________________________________________________________________________(insert full name, residential address and occupation)

In my capacity of returning officer for the constituency of ________________________________________________ ,

I appoint you to be deputy returning officer for Polling Division No. (or in the case of a hospital, personal carefacility or remand centre insert name of facility) (or in the case of advance, temporarily displaced voter or mobilepolling insert type of poll) in the constituency, there to take the votes of the voters. You are authorized andrequired to open the polling place and conduct the taking of the votes of the voters at the polling place on the______________________ day(s) of ________________________ , at 9:00 a.m. (or as the case may be) at (heredescribe particularly the place in which the voting is to be held) and there to keep the polling place open duringthe hours prescribed by law, and to do and perform in that polling place all acts and duties required to beperformed by the deputy returning officer appointed to act, and, after counting the votes given, to return to methe ballot box sealed with your seal (or in the case of hospital, remand centre or temporarily displaced voterpolling forward to the Chief Electoral Officer the ballot box containing the ballot envelopes) and enclosing theballots, envelopes, voters’ list(s) and other documents required by law, together with this appointment.

Given under my hand this ______________ day of _______________________ , ____________ .

____________________________________________________Signature of Returning Officer

2 Jan 1998 cE-6.01 Reg 2.

FORM Q[Section 10 of the Act]

Oath or Declaration of Deputy Returning Officer

I, _________________________________________________________________________________________ , appointeddeputy returning officer for the Polling Division No. (or in the case of a hospital, personal care facility or remandcentre insert name of facility) (or in the case of advance, temporarily displaced voter or mobile polling insert typeof poll) of the constituency of____________________________ , swear (or solemnly affirm) that I am legallyqualified to act as deputy returning officer, and that I will act faithfully in that capacity without partiality, fear,favour or affection.


Sworn (or solemnly affirmed) before me at the _____________ ____________________________________of _______________________ in the Province of Saskatchewan Signature of Deputy Returning Officerthis ___________ day of________________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.

17ELECTION FORMS


FORM R[Section 37 of the Act]

Appointment of Supervisory Deputy Returning Officer

To:___________________________________________________________________________________________________ ,(insert full name, residential address and occupation)

In my capacity of returning officer for the constituency of ________________________________________________ ,

I appoint you to be supervisory deputy returning officer for the central polling place at (here describe particularlythe place in which the voting is to be held) in the constituency, there to attend throughout polling day,the ________________________ day of ____________________________ , _____________ , for the purpose of keepingme fully informed with respect to matters affecting or likely to affect peace and good order in the central pollingplace.

Given under my hand this _____________ day of _____________________ , ___________ .


2 Jan 1998 cE-6.01 Reg 2.

FORM S[Section 37 of the Act]

Oath or Declaration of Supervisory Deputy Returning Officer

I, __________________________________________________ , appointed supervisory deputy returning officer for thecentral polling place at (here describe particularly the place in which the voting is to be held) in the constituencyof _____________________________________________ , swear (or solemnly affirm) that I am legally qualified to actas supervisory deputy returning officer, and that I will act faithfully in that capacity without partiality, fear,favour or affection.


Sworn (or solemnly affirmed) before me at the _____________ _____________________________________of _______________________ in the Province of Saskatchewan Signature of Supervisory Deputy Returning Officer

this ___________ day of________________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.


18

E-6.01 REG 2

FORM T[Section 13 of the Act]

Appointment of Poll Clerk

To:__________________________________________________________________________________________________(insert full name, residential address and occupation)

In my capacity of deputy returning officer for Polling Division No. (or in the case of a hospital, personal carefacility or remand centre insert name of facility) (or in the case of advance, temporarily displaced voter ormobile polling insert type of poll) in the constituency of ________________________________________________ ,I appoint you to be poll clerk for that polling place.

Given under my hand this ______________ day of __________________ , ________.

____________________________________________________Signature of Deputy Returning Officer

2 Jan 1998 cE-6.01 Reg 2.

FORM U[Section 13 of the Act]

Oath or Declaration of Poll Clerk

I, ________________________________________________________________________________ , appointed poll clerkfor Polling Division No. (or in the case of a hospital, personal care facility or remand centre insert name offacility) (or in the case of advance, temporarily displaced voter or mobile polling insert type of poll) in theconstituency of __________________________________________________________________ , swear (or solemnlyaffirm) that I am legally qualified to act as poll clerk and that I will act faithfully in that capacity and also in thecapacity of deputy returning officer, if so required, according to law, without partiality, fear, favour or affection.


Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Poll Clerkthis ___________ day of _______________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.

19ELECTION FORMS


FORM V[Section 78 of the Act]

Oath or Declaration of Interpreter

I, _______________________________________ swear (or solemnly affirm) that I will faithfully translate any oath,(insert full name)

declaration or lawful questions that the deputy returning officer shall require me to put to the voter and that I willfaithfully translate the voter’s answers.


Sworn (or solemnly affirmed) before me at the ______________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Interpreterthis ___________ day of________________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.

FORM W[Section 14 of the Act]

Oath or Declaration of Secrecy

Constituency of _______________________________________________________________________________________

Polling Division No. (or in the case of a hospital, personal care facility or remand centre insert name of facility)(or in the case of advance, temporarily displaced voter or mobile polling insert type of poll).

I, ________________________________________________________________________ , swear (or solemnly affirm):(insert full name, residential address and occupation)

1 That I will not attempt to ascertain and will by every means in my power prevent any other person fromascertaining how any person is about to vote or has voted at this election, except as may be necessary andproper in the case of persons blind or unable to read or incapable of marking their ballot papers as providedin The Election Act, 1996;

2 That I will not communicate to any person any information of any kind that may enable or assist anyperson to ascertain the candidate for whom any person has voted; and

3 That I will in all respects maintain and aid in maintaining the absolute secrecy of the voting at this pollingplace.


Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Personthis ___________ day of _______________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.


20

E-6.01 REG 2

31 Oct 2014 SR 85/2014 s5.

FORM Y[Sections 77 and 78 of the Act]

Oath or Declaration of Friend of Voter

You swear (or solemnly affirm):

That you know (full name of voter who has a disability that significantly restricts the voter’s ability to voteor voter who is unable to understand the English language) who has applied to vote at this polling place, andyou have heard the voter take the oath or make the declaration in Form X of The Election Act, 1996 andbelieve the matters sworn to are true in substance and in fact;

That you have been requested by (full name of voter who has a disability that significantly restricts thevoter’s ability to vote or voter who is unable to understand the English language) to mark the ballot paper,and you will keep secret the name of the candidate being marked for the voter on the ballot paper; and

That you have not acted and will not act for any more than two voters who have a disability that significantlyrestricts the voter’s ability to vote or voters who are unable to understand the English language, at thiselection (to be included only with respect to the Oath or Declaration of a friend who marked the ballot paperfor a voter who has a disability that significantly restricts the voter’s ability to vote or voter who is unable tounderstand the English language).


31 Oct 2014 SR 85/2014 s5.

FORM X[Sections 77 and 78 of the Act]

Oath or Declaration of Inability to Mark Ballot Paper

You swear (or solemnly affirm) that you have a disability that significantly restricts your ability to vote, orthat you do not understand the English language (as the case may be).


21ELECTION FORMS


}

FORM Z[Sections 93, 100, 108, 116, 124, 135 and 141 of the Act]

Oath or Declaration of Poll Clerk after Closing ofthe Polling Place for Voting

I, ___________________________________________ , poll clerk for Polling Division No. (or in the case of a hospital,personal care facility or remand centre insert name of facility) (or in the case of advance, temporarily displacedvoter or mobile polling insert type of poll) in the constituency of __________________________________________ ,swear (or solemnly affirm) that the poll book for the polling place kept under the direction of______________________________________________________________________________________________________ ,

(insert full name)who acted as deputy returning officer, has been kept by me correctly to the best of my skill and judgment; thatthe total number of votes cast according to the poll book is __________ ; and that to the best of my knowledgeand belief it contains a true and exact record of the voters who voted at the polling place.

Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Poll Clerkthis ___________ day of _______________________ , ________ .


2 Jan 1998 cE-6.01 Reg 2.


22

E-6.01 REG 2

2 Jan 1998 cE-6.01 Reg 2.

FORM AA[Sections 93, 100, 108, 116, 126, 135 and 143 of the Act]

Oath or Declaration of Deputy Returning Officer after Closingof the Polling Place for Voting

I, ______________________________________, deputy returning officer for Polling Division No. (or in the case of ahospital, personal care facility or remand centre insert name of facility) (or in the case of advance, temporarilydisplaced voter or mobile polling insert type of poll) in the constituency of ________________________________ ,swear (or solemnly affirm) that, to the best of my knowledge and belief:

1 The poll book kept for the polling place under my direction has been kept correctly;

2 The total number of votes cast according to the poll book is _______________________ ;

3 The poll book contains a true and exact record of the votes cast at the polling place;

4 I have correctly counted the votes cast for each candidate (not to be included in the oath of a deputyreturning officer conducting the taking of the votes of the voters in a hospital, remand centre or temporarilydisplaced voter poll);

5 I have performed all duties required of me by law;

6 The voters’ list, poll book, and other documents, etc., required by law to be returned by me to the returningofficer have been faithfully and truly prepared and placed in the ballot box and are contained in the ballotbox returned by me to the returning officer, which was locked and sealed by me in accordance with TheElection Act, 1996 and remained so locked and sealed while in my possession;

7 I have forwarded to the Chief Electoral Officer, Regina, the ballot box containing the ballot envelopes (to beincluded only with respect to the oath of a deputy returning officer who conducted a hospital, remandcentre or temporarily displaced voter poll at a general election).

Sworn (or solemnly affirmed) before me at the _____________ ____________________________________of _______________________ in the Province of Saskatchewan Signature of Deputy Returning Officerthis ___________ day of________________________ , ________ .


}

23ELECTION FORMS


FORM BB[Sections 93, 100, 108, 116, 126, 135 and 143 of the Act]

Receipt for Ballot Box

(To be Retained by Deputy Returning Officer)

Constituency of ________________________________________________________________________________________

Polling Division No. (or in the case of a hospital, personal care facility or remand centre insert name of facility)(or in the case of advance, temporarily displaced voter or mobile polling insert type of poll).

I received from _________________________________________________________ , deputy returning officer for theabove-described polling division, the ballot box used in the recent election for the voting held in the pollingdivision, the ballot box being locked and sealed as provided by The Election Act, 1996, and delivered the ballotbox, in the same condition as I received it, to _____________________________________________________________of ________________________________________________ , the returning officer for the above-named constituency.

Dated at ______________________________ , Saskatchewan, this _______ day of _________________ , ______ .

________________________________________ _______________________________________________Signature of Deputy Returning Officer Signature of Messenger

2 Jan 1998 cE-6.01 Reg 2.

FORM CC[Sections 93, 100, 108, 116, 126, 135 and 143 of the Act]

Oath or Declaration of Messenger who Delivers the BallotBox to the Returning Officer

I, ___________________________________________________ , swear (or solemnly affirm) that I am the person towhom __________________________________________________ , deputy returning officer for Polling Division No.(or in the case of a hospital, personal care facility or remand centre insert name of facility) (or in the case ofadvance, temporarily displaced voter or mobile polling insert type of poll) of the ____________________________

(City, Town or Village)of _____________________________ in the constituency of ____________________________________ , entrusted theballot box for the polling place to be delivered to ___________________, the returning officer;

1 That the ballot box which I delivered to the returning officer this day is the ballot box I so received; and2 That I have not opened it and that it has not been opened by any other person since I received it from the

deputy returning officer.


Sworn (or solemnly affirmed) before me at the _____________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Messengerthis ___________ day of _______________________ , ________ .

_________________________________________________________Signature of Returning Officer

}

2 Jan 1998 cE-6.01 Reg 2.


24

E-6.01 REG 2

FORM DD[Sections 71, 81, 82, 99, 107, 115 and 123 of the Act]

Declaration of Voter

Part 1: Voter Making a Declaration (Declaring Voter)Voter’s Polling

Date of Writ , Voter’s Constituency Division Number

Last Name of Voter First Name of Voter Middle Name or Initial of Voter

G Male G Female Date of Birth (yyyy/mm/dd) Occupation (e.g., labourer)

Number & Street (e.g., 123 Main Street) Apartment/Unit (e.g., Apt. 4 or Unit 4) or Land Location (e.g., NE20-16-10 W3M)

, SaskatchewanCity, Town or Village (e.g., Ile-a-la-Crosse) Postal Code (e.g., S4N 6B2)

Mailing Address (if different than ordinary residential address given above)

Number & Street or Post Office Box Apartment/Unit

, SaskatchewanCity, Town or Village (e.g., Ile-a-la-Crosse) Postal Code (e.g., S4N 6B2)

Part 2: Declaration of Voter (to be completed by voter applying for a ballot)

! I am the full age of 18 years or will attain the full age of 18 years on or before Polling Day;! I am a Canadian citizen or a British subject and was qualified as a voter (in Saskatchewan) on June 23, 1971;! I have ordinarily resided in Saskatchewan for at least six months immediately preceding the day the writ was

issued;! I was ordinarily resident in the above-mentioned constituency on the day the writ was issued; ! I am not disqualified pursuant to section 17 of The Election Act, 1996 to vote at this election; ! I have not already voted at this election; and

I make this solemn declaration conscientiously, believing it to be true and knowing that it is of the same force and effectas if made under oath and by virtue of the Canada Evidence Act.

Date Signature of Applicant/Voter

G I do not want my name added to the Register of Voters

25ELECTION FORMS


31 Oct 2014 SR 85/2014 s5.

Part 3: Voter Vouching (for an individual who is not on the voters’ list and does not have acceptable identification)

I, , being a qualified voter in the above-named constituency, appearing on the voter’s list, (Printed Name of Voter Vouching)

having provided satisfactory evidence of the voter’s identity and ordinary residence at (Address of Voter Vounching)

to the poll clerk, confirm that the declaring voter is known to me and that the information provided by the declaringvoter as to identity and place or ordinary residence is accurate and that I have only vouched for one voter at thiselection.

Signature of Voter Vouching for Declaring Voter

Part 4: For Use by Election Officer

Acceptable identification presented by voter who is vouching

Voter who is vouching is on the Voters’ List

Yes

Yes

No

No

Signature of Election Officer


26

E-6.01 REG 2

Ballot Paper Account and Poll Statement(To be made by deputy returning officer, at close of the taking of the votes of the voters,

in accordance with sections 93, 100, 108, 116, 124, 135 and 141)

Constituency of ________________________________ Polling Division No. ______________________________(or in the case of a hospital, personal carefacility or remand centre insert name offacility) (or in the case of advance, displacedvoter or mobile polling insert type of poll )

1 Total number of names on the voters’ list

Ballot Paper Account

2 Number of ballot papers (Form A) received from returning o

(or)

Number of ballot papers (Form B) received from returning o

3 Number appearing in poll book as having voted

4 Number of unused ballot papers (Form A)

(or)

Number of unused ballot papers (Form B)

5 Number of ballot papers (Form A) spoiled or declined

(or)

Number of ballot papers (Form B) spoiled or declined

6 Number of ballot papers unaccounted for (if any)

Total

NOTE: These totals must agree.

(To be completed with respect to all polling places except hospital, remand centre or temporarily displaced voter polls.)

7 Number of voters appearing in poll book as having voted:

(a) without making a declaration

(b) after making a declaration

Form EE[Sections, 93, 100, 108, 116, 124, 135 and 141 of the Act]

27ELECTION FORMS


(To be completed only with respect to polling places in a hospital, remand centre or temporarily displaced voter poll.)

8 Number of voters appearing in poll book as having voted, who:

(a) reside in the constituency

(b) do not reside in the constituency

Total

NOTE: The total under 7 or 8 must agree with 3.

(To be completed with respect to all polling places except polling places in a hospital, remand centre or temporarilydisplaced voter poll.)

9 Number of ballots cast for ( insert name of candidate )

Number of ballots cast for ( insert name of candidate )





10 Number of rejected ballots

Total

NOTE: This total must agree with 7.

I certify that the above statement is correct.

Dated at _________________ , this___________ day of _______________________ , _________ .

_________________________________________ ____________________________________________Poll Clerk Deputy Returning O r

(Candidates or representatives may also sign.)

13 Jly 2001 SR 47/2001 s3.


28

E-6.01 REG 2

31 Oct 2014 SR 85/2014 s5.

FORM FF[Section 77 of the Act]

Ballot Template

This template, valid for a ballot paper (Form A) with a maximum of eight candidates, is for the use of a voterwho has a disability that significantly restricts the voter’s ability to vote and who does not wish to be assistedby a friend or the deputy returning officer in marking the ballot.

The portion of the template containing the circular holes shall be coloured black with instructions reading asfollows:

General Instruction to Deputy Returning Officer

! Voters who have a disability that significantly restricts their ability to voteARE NOT required to take the oath of an incapacitated voter when usingthis template

! Your poll clerk will make the usual entry in the poll book, i.e. “voted”

Procedure in the handling of the Ballot Paper

! Detach voter’s ballot paper from the book and fold it in the prescribed way

! Unfold ballot paper and place it inside template in such a way that the firstcircle on the ballot is aligned with the first circle on the template

! IF ASKED, inform voter of the order in which the names of the candidatesappear on the ballot paper

! Direct the voter to refold his/her ballot paper, after marking it, using as aguide the ridges left when you folded it

29ELECTION FORMS


FORM GG[Section 140 of the Act]

Notice to Voters - Northern Constituencies

Public notice is given that registration will be made of all persons qualified to vote, in the election now pending, at the

polling places named in my proclamation dated the day of , .

The enumerator appointed by me for the territory adjacent to the polling place located at

is of in this constituency.

Application for registration may be made to the enumerator by any person ordinarily resident in the territory adjacent

to that polling place at any time from a.m./p.m. to p.m. from

to .

The enumerator will sit for revision of the voters’ list at

between the hours of and from to .

Given under my hand at this day of , .

Returning Officer

31 Oct 2014 SR 85/2014 s5.


30

E-6.01 REG 2

FORM HH[Sections 58 and 191 of the Act]

Directions for the Guidance of Voters

A voter may vote for one candidate only.

Voter’s Declaration – A patient in a hospital, a remand prisonerin a remand centre, or a temporarily displaced voter may voteonly if he or she makes a voter’s declaration at the pollingplace.

Persons whose names appear on the voters’ list may be requiredto make the declaration and if so required will be allowed tovote only after making the voter’s declaration.

HOW TO VOTE

Step 1: On receiving a ballot paper, the voter shall proceed to avoting station provided for the purpose of voting.

Step 2: The voter shall mark the ballot paper by placing a crossor other mark that clearly indicates the voter’s choice in thecircle to the right of the name of the candidate for whom thevoter intends to vote. An example is below.

DO NOT MARK ANY OTHER PART OF THE BALLOT

In the following example, the Candidates are Bill Brown, JaneHamon, Joseph O’Neil and Alice Smith.

The voter has marked his or her ballot paper in favour of AliceSmith.

Bill BROWN(Political Affiliation)

Farmer

Jane HAMON(Political Affiliation)

Lawyer

Joseph O’NEIL(Political Affiliation)

Printer

Alice SMITH(Political Affiliation)

Teacher

Step 3: After marking the ballot paper, the voter will fold theballot paper so that the names of the candidates and the voter’smark on the ballot are concealed, but the initials of the DeputyReturning Officer are exposed.

Leave the voting station with your ballot.

Step 4: (a) After leaving the voting station, the voter will immediatelydeliver the folded ballot paper to the Deputy Returning Officer,without showing the front to anyone or displaying the ballotpaper so as to make the name of the candidate for whom he orshe has voted known to any person.(b) The Deputy Returning Officer will examine the initials onthe ballot paper to confirm it is the ballot paper given to thevoter by the Deputy Returning Officer.(c) After removing the counterfoil, the Deputy ReturningOfficer will give the ballot back to the voter.

Step 5: The voter will deposit the ballot in the ballot box orallow the Deputy Returning Officer to deposit the ballot in theballot box.

Step 6: The voter will leave the polling place immediately afterthe ballot has been deposited in the ballot box.

If a voter inadvertently spoils a ballot paper so that he or shecannot conveniently use it as he or she desires, he or she mayreturn it to the Deputy Returning Officer who will give him orher another.

If a voter votes for more than one Candidate, or places anymark on the ballot paper by which he or she can beidentified, his or her vote will be void and WILL NOT becounted.

If a voter fraudulently takes a ballot paper out of the pollingplace or fraudulently delivers to the Deputy Returning Officerto be placed in the ballot box any other paper than the ballotpaper given to him or her by the Deputy Returning Officer, heor she will be disqualified from voting for the next five yearsand is liable to imprisonment for not more than one year.

Warning189(1) No person shall unlawfully take down, cover up, mutilate, deface or alter an election proclamation, notice or other document required to be posted pursuant to thisAct. Any person violating the provision of subsection 189(1) is guilty of an offence and, subject to subsection 216(2) of this Act, if convicted, is liable to a fine of notmore than $5,000.00 or to imprisonment for a term not exceeding two years or to both.

31 Oct 2014 SR 85/2014 s5.

31ELECTION FORMS


FORM II[Sections 58, 191 and 216 of the Act]

Notice as to Secrecy of Voting

It is the sworn duty of every person in attendance at this polling place or at the counting of the votes not toattempt to ascertain how any person is about to vote or has voted and not to communicate any informationobtained at the polling place that may enable or assist any person to ascertain how any person has voted.

It is further the sworn duty of every such person by all proper means to maintain and aid in maintaining theabsolute secrecy of the voting at this polling place.

A person who acts in contravention of his or her duty in any of these particulars is liable to a fine not exceeding$5,000 or to imprisonment for not more than two years, or to both.

The Election Act, 1996 further provides that every person who fraudulently and without authority destroys, takes,opens or otherwise interferes with a ballot box or book or packet of ballot papers or ballot paper or ballot in use orused for the purpose of an election, or who attempts to do so, is disqualified from voting at any election for the nextfive years and is liable to imprisonment for not more than one year. Also pursuant to the Act, a returning officer,election clerk, supervisory deputy returning officer, deputy returning officer, poll clerk or other officer engaged inthe election who is guilty of a contravention of that provision is liable to imprisonment, without the alternative ofa fine, for not more than two years.

____________________________________________________Chief Electoral Officer

2 Jan 1998 cE-6.01 Reg 2.

FORM JJ[Sections 85 and 125 of the Act]

Statement by Deputy Returning Officer Respecting Voterswho Made the Declaration on Election Day

I, the undersigned, deputy returning officer for Polling Division No. (or in the case of a personal care facility, or ahospital or remand centre in a by-election insert name of facility) in the constituency of ______________________ ,certify that at the election held this _____________ day of _______________________ , ___________ , the personsnamed in the following list made the voter’s declaration on that date for the reasons set forth opposite theirrespective names:

Name of Voter Address Occupation Constituency Reasons forRequiring theDeclaration

Dated at _________________ , Saskatchewan, this _______ day of _________________________ , _________ .

____________________________________________ __________________________________________________reciffO gninruteR ytupeD fo erutangiSkrelC lloP fo erutangiS

(Candidates or representatives may also sign)

2 Jan 1998 cE-6.01 Reg 2.


32

E-6.01 REG 2

FORM KK[Sections 93 and 135 of the Act]

Voters who voted at(in the case of advance polling insert Advance Poll)

(or in the case of mobile polling insert Mobile Poll (Held On Any Advance Polling Day)or Mobile Poll (Held On Polling Day))

List of voters voting at Advance Poll in the Constituency of ________________________________________________on (here state the days, dates, month and year established for advance polling in the constituency)

(or)

List of voters voting at Mobile Poll in the Constituency of __________________________________________________at (here state the location(s)) on (day(s), date(s), month and year established for mobile polling in the constituency)

To be made by Deputy Returning Officer and furnished to Returning Officer at the close of poll held on anyadvance polling day in accordance with section 135 of The Election Act, 1996.

(or)

To be made by Deputy Returning Officer and furnished to Returning Officer at the close of any mobile poll held onany advance polling day in accordance with section 93 of The Election Act, 1996.

(or)

To be made by Deputy Returning Officer and furnished to Returning Officer at the close of mobile poll held onpolling day in accordance with section 93 of The Election Act, 1996.

Name of Voter Location of Residence Post Office Polling DivisionOf Voter Address Occupation Number Remarks

(For advance polling or mobile polling held on any advance polling days include the following statement)

Note: Those voters whose names appear on the above list shall be removed from the Revised Voters’ List priorto opening of polling places on polling day.

_________________________________________________Signature of Deputy Returning Officer

2 Jan 1998 cE-6.01 Reg 2.

FORM LL[Sections 21, 22, 24 and 28 of the Act]

Voters’ List

Constituency of _________________________ Polling Division No. ___________________________________________(or in the case of a personal care facilityinsert name of facility)

Election Date ______________________________

eciffO tsoPro )laruR( noitacoL dnaL PostalNumber Street and Number (Cities and Towns) Name Occupation Address Code

2 Jan 1998 cE-6.01 Reg 2.

33ELECTION FORMS


31 Oct 2014 SR 85/2014 s5.

FORM MM[Section 25(6) of the Act]

Certificate of Returning Officer

I certify that the foregoing is a true copy of the voters’ list in Polling Division No. (or in the case of a

personal care facility insert name of facility) of the constituency of

as prepared by me for use in the election now pending of a member of the Legislative Assembly of

Saskatchewan for that constituency.

Dated this day of , .

Signature of Returning Officer

Name of Returning Officer Phone Number and Address of Returning Officer

Revision will take place at

FORM NN[Section 28 of the Act]

Certificate of Revision

(Here the Returning Officer shall make any addition to the list that he or she finds necessary.)

I certify that the foregoing is a corrected list of the voters in Polling Division No. (or in the case of a

personal care facility insert name of facility) of the constituency of

as revised (or if no correction is made as finally approved) by me this day of

.


31 Oct 2014 SR 85/2014 s5.


34

E-6.01 REG 2

17 Feb 2006 SR 6/2006 s4.

FORM OO [Section 87 of the Act]

Absentee Voter Declaration

Declaration of Voter

• I am the full age of 18 years or will attain the full age of 18 years on or before Polling Day; • I am a Canadian citizen or a British subject who was qualified as a voter on June 23, 1971; • I have ordinarily resided in Saskatchewan for at least six months immediately preceding the day the

writ was issued; • I was ordinarily resident in the above-mentioned constituency on the day the writ was issued; • I am not disqualified pursuant to section 17 of The Election Act, 1996 to vote at this election; • I am unable to vote at an advance poll or on Polling Day in the constituency in which I am an

ordinary resident; and • I have not already voted at this election.

I understand that upon issuance of an Absentee Ballot Kit under the absentee voters provisions, I will be deemed to have voted.

I make this solemn declaration conscientiously, believing it to be true and knowing that it is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.

Signature of Applicant/Voter Date

35ELECTION FORMS


17 Feb 2006 SR 6/2006 s4.

FORM PP [Section 88 of the Act]

Certificate Envelope

To be completed by the Returning Officer:

Constituency of

of Name of Voter

Address (Street and Number) and (apt. or unit) or Land Location

, Saskatchewan City, Town or Village Postal Code

To be completed by the absentee voter:

Insert ballot envelope (E-130A) in this envelope, seal and complete the following certificate.

I certify that I am entitled to vote pursuant to sections 87 to 89 of The Election Act, 1996, because I am unable to vote at an advance poll or on Polling Day in the constituency in which I am an ordinary resident and that enclosed in this envelope is a ballot envelope that contains the ballot received by me and marked by me.

Dated this day of , 20 .

Signature of Voter

FORM QQ[Section 88 of the Act]

Outer Envelope to the Returning Officer

Returning Officer

Constituency of ________________________________________________________________________________________

_______________________________________________________________________________________________________(Address of Returning Officer)

2 Jan 1998 cE-6.01 Reg 2.


36

E-6.01 REG 2

17 Feb 2006 SR 6/2006 s4.

FORM RR [Section 89 of the Act]

Statement of Absentee Ballots Mailed or Delivered to the Returning Officer

Constituency of

NUMBER OF BALLOTS

Number of certificate envelopes deposited in ballot box

Number of unopened certificate envelopes rejected

Number of unopened outer envelopes received after the deadline

Number of ballot papers not returned (if any)

Number of ballot papers spoiled or declined

Number of unused ballot papers

B stollab eetnesba latoT

NUMBER OF BALLOT PAPERS

Total number of ballot papers assigned to the absentee voting process C

The seal locking this ballot box bears number . I certify that the above statement is correct.


reciffO gninruteR fo erutangiS

BALLOTS COUNTED FOR EACH CANDIDATE

Number of ballots cast for:






Number of rejected ballots

A xob tollab ni stollab eetnesba latoT

37ELECTION FORMS


FORM SS[Sections 31, 44 and 238 of the Act]

Nomination Paper

Part I

We, the undersigned voters of the constituency of ________________________________________________________ ,nominate (name, political affiliation, if any, and occupation) of (address) as a candidate at the election about to beheld of a member to represent that constituency in the Legislative Assembly of Saskatchewan.

If the person is absent from Saskatchewan it must be stated here.

Signature of Voter Address of Voter Occupation of Voter Signature of Witness

(Several signatures of voters may be bracketed and a witness need only sign once opposite the bracket for the wholeseries of signatures that he or she witnessed).

Part IICONSENT OF CANDIDATE

I, ________________________________ , nominated in the foregoing nomination paper hereby consent to such(name of candidate)

nomination.

I declare that the name and address of my business manager is ____________________________________________of _______________________________________ in the Province Saskatchewan and that the name and address of

(state residential address)

my auditor is _______________________________ of _______________________________________________________in the Province of Saskatchewan.

I request that my name be set forth on the ballot paper in the following form:

I request that my political affiliation be set forth on the ballot paper in the following form:

I designate the following as my address for service of all notices, documents or other papers required to be servedupon me pursuant to either The Election Act, 1996 or The Controverted Elections Act, namely:

Signed by the above named(name of candidate)in the presence of ___________________________ _____________________________________________

Signature of Candidate

___________________________________________Witness

}


38

E-6.01 REG 2

Part IIICONSENT OF BUSINESS MANAGER

I, ________________________________________________ of _________________________________________________ ,being a qualified voter in the Province of Saskatchewan, hereby consent to my appointment to act as businessmanager for __________________________________________________________ , the candidate nominated at theelection about to be held of a member to represent the constituency of ______________________________________in the Legislative Assembly of Saskatchewan.

Dated at ________________ , in the Province of Saskatchewan, this ________ day of _____________ ,__________ .

_____________________________________________Signature of Business Manager

Part IVAFFIDAVIT OF ATTESTATION TO BE TAKEN BY WITNESS

TO SIGNATURES OF NOMINATORS

I, _________________________________________ of _________________________________________________________in the Province of Saskatchewan, make oath and say (or solemnly affirm) that I know the nominators whosesignatures to the foregoing nomination paper I have witnessed and that they are duly qualified voters in theconstituency of __________________________________ at the election about to be held and that each of them signedthe foregoing nomination paper in my presence.

Sworn (or solemnly affirmed) before me at the ______________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Person Attestingthis ___________ day of________________________ , ________ .


}

Part VAFFIDAVIT OF ATTESTATION TO BE TAKEN BY WITNESS

TO SIGNATURE OF CANDIDATE

I, __________________________________________ of ________________________________________________________in Province of Saskatchewan, make oath and say (or solemnly affirm) that I know __________________________ ,nominated as a candidate in the foregoing nomination paper, and that he or she signed his or her consent to thenomination in my presence.

Sworn (or solemnly affirmed) before me at the ______________ _______________________________of _______________________ in the Province of Saskatchewan Signature of Person Attestingthis ___________ day of________________________ , ________ .


}

2 Jan 1998 cE-6.01 Reg 2.

39ELECTION FORMS


FORM TT[Sections 46 and 48 of the Act]

Certificate Respecting Nomination Paper and Deposit

Constituency of ________________________________________________________________________________________

I acknowledge receipt of a valid nomination paper filed on behalf of ________________________________________and nominating him or her as a candidate at the election now about to be held of a member to represent the aboveconstituency in the Legislative Assembly of Saskatchewan. I also acknowledge receipt of a deposit of $100 madeon his or her behalf.

Dated at ______________ , Saskatchewan, this _________ day of ____________________ , __________ .


FORM UU[Section 52 of the Act]

Withdrawal of Candidate

Constituency of ________________________________________________________________________________________

I, ____________________________________________ , a candidate nominated for the above constituency, withdraw.

Dated at _________________ , Saskatchewan, this _______ day of ________________ , _______ .

____________________________________________________Signature of Candidate

2 Jan 1998 cE-6.01 Reg 2.

2 Jan 1998 cE-6.01 Reg 2.


40

E-6.01 REG 2

FORM VV [Section 261 of the Act]

Candidate’s Return of Election Expenses On Behalf of

Name of Candidate

Return

I, of sserddA emaN

edoC latsoP )sserdda laitnediser eht morf tnereffid fi( sserddA gniliaM

Telephone Number Residence ( ) Business ( )

in the province of Saskatchewan, being the business manager of the above-named candidate at the election of a member to serve in the Legislative Assembly of Saskatchewan held on the day of

, in the constituency of make the following Return respecting the election expenses of the said candidate.

Signature of Business Manager

Date Note

1. This Return must be transmitted to the Returning Officer within three (3) months after Polling Day. Subsection 261(1) of the Act

2. This Return must be accompanied by the auditor’s report to the business manager of the candidate on the information given in this Return.

Subsection 261(1) of the Act

3. The commercial value of goods and services donated (other than volunteer labour or goods valued at $200.00 or less), and the difference between the amount paid and the commercial value of goods and services provided, are considered to be election expenses. If the total of “commercial value” is greater than the total of “amount paid” it is the larger of the two figures that is used in the calculation of election expenses incurred by the candidate. See definition of “commercial value”, Clause 220(c) of the Act.

4. A statement, signed and receipted, by the donor and by the business manager, supported by a verification from an independent commercial source of the amount expensed, must be submitted when making a claim of commercial value as an election expense.

Clauses 220(c) and 261(2)(a) of the Act

5. All payments of more than $25.00 must be accompanied by a supplier document that states the particulars of the election expense and by a receipt or cancelled cheque that provides proof of payment. The supplier documents and proofs of payment must be submitted with this Return.

Section 255 of the Act Subclause 261(2)(i) of the Act

41ELECTION FORMS


Designation of Reimbursement

I. Contributions Exceed Election Expenses

Section 269 of the Act

If the value of all contributions received exceeds the election expenses incurred by or on behalf of the candidate, the Minister of Finance shall:

(a) where the candidate was endorsed by a registered political party, pay any reimbursement to the chief official agent of the registered political party or the business manager, as directed by the candidate. (Indicate below to whom reimbursement is to be paid.)

__________________________________________________________________________________ Name of Payee

__________________________________________________________________________________ Address Postal Code

(b) where the candidate was not endorsed by a registered political party, pay no reimbursement.

II. Contributions and Reimbursement Exceed Election Expenses


If the value of all contributions received does not exceed the election expenses but the value of those contributions and the reimbursement calculated exceeds the election expenses incurred by or on behalf of the candidate, the Minister of Finance shall:

(a) where a candidate was endorsed by a registered political party, pay to the chief official agent of the registered political party or the business manager, as directed by the candidate, those contributions and the reimbursement less the election expenses (Indicate below to whom reimbursement is to be paid:)

__________________________________________________________________________________ Name of Payee


and to the business manager an amount equal to the election expenses less the contributions received;

(b) where a candidate was not endorsed by a registered political party, pay to the business manager an amount equal to the election expenses less the contributions received.


42

E-6.01 REG 2

Summary of Contributions and Expenses

I. Contributions __________________$ snoitubirtnoC

II. Expenses (a) Candidate’s Campaign Expenses $ __________________

__________________ $ sesnepxE ytteP )b( __________________ $ sesimerP fo eriH )c( __________________ $ gnisitrevdA )d( __________________ $ secivreS )e( __________________ $ deilppuS sdooG )f( __________________ $ elciheV fo eriH dna levarT )g(

(h) Undisputed Claims Unpaid $ __________________ __________________$ SESNEPXE LATOT

__________________ $ smialC detupsiD )i( Candidate Personal Expenses $ __________________

Note: Total Expenses (excluding (h) above) is used for the calculation of the reimbursement.

Part I

Contributions (a) Summary of Contributions

I. Value of Contributions

List below, by class of contributor, the aggregate amounts of (A) contributions in excess of $250.00, (B) contributions of $250.00 or less but more than $25.00, and (C) contributions of $25.00 or less, and the number of contributors of each class who have provided money, goods or services for the use of the candidate by way of a gift, loan, advance, deposit, or other form of assistance (includes goods or services donated or provided at other than their true value).

Class of Contributor Number of Contributors Value of Contributions

slaudividnI .1

snoitaroproC .2

snoinU edarT .3

snoitaicossA ro snoitazinagrO detaroprocninU .4

snosreP fo spuorG ro snosreP rehto ynA .5

Total Contributions

Total Contributions (Excluding Excess Amount)

43ELECTION FORMS


II. Contributions Exceed Election Expenses


If the value of all contributions and any reimbursement received exceeds the election expenses incurred by or on behalf of the candidate, the candidate’s business manager shall:

(a) where a candidate was endorsed by a registered political party, pay the excess amount to the chief official agent of the registered political party or the candidate’s constituency association, as directed by the candidate. If so, indicate to whom such payment has been made and affix to this Return the receipt or cancelled cheque that provides proof of payment.

__________________________________________________________________________________ Name of Payee


(b) where a candidate was not endorsed by a registered political party, pay the excess amount to the Minister of Finance. If so, affix to this Return a cheque payable to the Minister of Finance for subsequent deposit, in the general revenue fund, by the Chief Electoral Officer.

III. Death or Withdrawal of Candidate


If the candidate dies or withdraws from an election and prior to the death or withdrawal the value of all contributions to the candidate exceeds the candidate’s election expenses, the candidate’s business manager shall:

(a) where the candidate was endorsed by a registered political party, pay the excess amount to the chief official agent of the registered political party. If so, indicate to whom such payment has been made and affix to this Return the receipt or cancelled cheque that provides proof of payment.

__________________________________________________________________________________ Name of Payee


(b) where the candidate was not endorsed by a registered political party, pay the excess amount to the Minister of Finance. If so, affix to this Return a cheque payable to the Minister of Finance for subsequent deposit, in the general revenue fund, by the Chief Electoral Officer.

Further, if the candidate dies or withdraws before appointing a business manager, the candidate’s estate or the candidate shall pay the excess amount in accordance with the above.


44

E-6.01 REG 2

Part I

Contributions

(b) Detail of Contributions

Contributions include money provided to or on behalf of the candidate without compensation from the candidate and includes donations in kind.

Detail of the name of and total amount received from each contributor included in classes 1 to 5 in Part (a) who have provided money, goods or services by way of a gift, loan, advance, deposit or other form of assistance must be reported in the aggregate by classification in the appropriate schedule. Such contributions are to be identified in one of three categories: (A) contributions in excess of $250.00, (B) contributions of $250.00 or less but more than $25.00, and (C) contributions of $25.00 or less. The sum of the categories should reflect the total contributions received for the use of the candidate in each classification schedule.

Where a corporation, trust fund or constituency association makes a contribution, pursuant to subsection 240(6) of The Election Act, 1996, each such contribution must be accompanied by a statement which sets out the name of the person who authorized the contribution on behalf of the corporation, trust fund or constituency association, and the name of and the amount contributed by, each person who made a contribution in excess of $250.00 in a year and whose contribution was used to make up the funds contributed by the corporation, trust fund or constituency association.

Where a registered party makes a contribution, pursuant to subsection 240(7) of The Election Act, 1996,each such contribution must be accompanied by a statement which sets out the name of and the amount contributed by, each person who made a contribution in excess of $250.00 in a year and whose contribution was used to make up the funds contributed by the registered party.

A true and correct copy, certified by the business manager, for each such statement of contribution received pursuant to subsections 240(6) and (7) of the Act, must be affixed to this Return (ss.261(3)).

Revenue received by a candidate from fund-raising activities, meetings and sales of material of a promotional nature are deemed contributions. The total net proceeds from each source indicated must be recorded and, in the aggregate, reported in this Return.

The value of donations in kind must be recorded and included as a contribution received by the business manager where claimed as an election expense. Accordingly, commercial value is an election expense and a contribution concurrently.

45ELECTION FORMS


Schedule: 1. Individuals

(A) Contributions in excess of $250.00

Note: List below all contributions where the aggregate value of contributions exceeds $250.00.

tnuomA rotubirtnoC fo emaN

List additional contributors on separate sheet provided and affix to this Return.

List Attached Number of Pages Yes or No

srotubirtnoC fo rebmuN snoitubirtnoC )A( yrogetaC lla fo tnuomA latoT

(B) Contributions of $250.00 or less but more than $25.00

Note: Report the number of contributors and the total value of contributions received, from any individual, of $250.00 or less but more than $25.00.

srotubirtnoC fo rebmuN snoitubirtnoC )B( yrogetaC lla fo tnuomA latoT

(C) Contributions of $25.00 or less

Note: Report the number of contributors and the total value of contributions received, from any individual, of $25.00 or less.

srotubirtnoC fo rebmuN snoitubirtnoC )C( yrogetaC lla fo tnuomA latoT

srotubirtnoC fo rebmuN latoT

snoitubirtnoC latoT

(Sum of Categories (A), (B) and (C))

Enter Totals on Part 1(a) Summary of Contributions Line 1.


46

E-6.01 REG 2

Schedule: 2. Corporations








Note: Report the number of contributors and the total value of contributions received, from any corporation, of $250.00 or less but more than $25.00.



Note: Report the number of contributors and the total value of contributions received, from any corporation, of $25.00 or less.



snoitubirtnoC latoT



47ELECTION FORMS


Schedule: 3. Trade Unions








Note: Report the number of contributors and the total value of contributions received, from any trade union, of $250.00 or less but more than $25.00.



Note: Report the number of contributors and the total value of contributions received, from any trade union, of $25.00 or less.



snoitubirtnoC latoT




48

E-6.01 REG 2

Schedule: 4. Unincorporated Organizations or Associations








Note: Report the number of contributors and the total value of contributions received, from any unincorporated organization or association, of $250.00 or less but more than $25.00.



Note: Report the number of contributors and the total value of contributions received, from any unincorporated organization or association, of $25.00 or less.



snoitubirtnoC latoT



49ELECTION FORMS


Schedule: 5. Any other Persons or Groups of Persons








Note: Report the number of contributors and the total value of contributions received, from any other person or group of persons, of $250.00 or less but more than $25.00.



Note: Report the number of contributors and the total value of contributions received, from any other person or group of persons, of $25.00 or less.



snoitubirtnoC latoT




50

E-6.01 REG 2

Part I

Contributions

(c) Proceeds from Other Sources - Summary

Set out below the aggregate value of net proceeds received by the candidate from the sources as indicated.

tnuomA ecruoS

1. Sales of tickets to or monies paid to each dinner, rally, public meeting and other fund-raising function.

2. Collections made at events mentioned in item 1 above or other events.

3. Sales of pins, buttons, flags, emblems, hats, banners, literature and other materials.

latoT

Enter Total under Schedule: 5. Any Other Persons or Groups of Persons of Part 1(b) Detail of Contributions

Part II

Expenses

Candidate’s Personal Expenses

Set out the total amount of the candidate’s personal expenditures that were paid by him personally and reported to the business manager pursuant to clause 261(2)(b) of the Act. A detailed statement by the candidate supported by supplier documents, bills and proofs of payment of the amounts expensed must be attached to this Return.

Total Amount ________________

Note: Personal expenses of the candidate are not election expenses. Subclause 220(h)(ix) of the Act.

51ELECTION FORMS


(a) Candidate’s Campaign Expenses

Set out below the aggregate amount of travel, meal and accommodation expenditures incurred by or on behalf of the candidate and paid by the business manager pursuant to subclause 220(f)(iv) of the Act. Attach particulars of the amounts expensed by the candidate supported by supplier documents, bills and proofs of payment.

Part II

Expenses

(b) Petty Expenses

Set out below the petty expenses paid under the authority of the business manager pursuant to section 259 of the Act. Attach and number consecutively, the statement(s) of particulars of the amounts expensed supported by supplier documents, bills and proofs of payment.

diaP tnuomA sralucitraP .oN .cesnoC

Total

Note: Include only costs associated with expenditures to or within the constituency.

(A) Travel levarT riA elciheV latneR elciheV etavirP

Kilometres travelled at cents per kilometre ixaT/eraF suB )gnikrap ,leuf ,stnacirbul ,ecnarusnI( rehtO

Total of (A)

(B) Accommodation letoM ,letoH ecnediseR yraropmeT

Total of (B)

(C) Living Allowance slaeM

Total of (C)

sesnepxE ngiapmaC s’etadidnaC latoT ))C( dna )B( ,)A( seirogetaC fo muS(


52

E-6.01 REG 2

Part

II

Expe

nses

(c)

Hire

of P

rem

ises

Set

out

bel

ow th

e na

me

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny a

nd a

ssoc

iatio

n fro

m w

hom

pre

mis

es w

ere

acqu

ired

for t

he p

urpo

se o

f the

ele

ctio

n,

with

a d

escr

iptio

n of

the

prem

ises

so

acqu

ired,

the

purp

ose

for w

hich

and

the

leng

th o

f tim

e du

ring

whi

ch th

e sa

me

wer

e us

ed, t

he a

mou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue th

ereo

f. A

ttach

sup

plie

r do

cum

ents

, bill

s an

d pr

oofs

of

paym

ent,

num

ber

them

con

secu

tivel

y an

d lis

t th

em in

the

pro

per

colu

mns

be

low

.

Part

II

Expe

nses

(d)

Adv

ertis

ing

Set

out

bel

ow th

e co

st o

f acq

uirin

g th

e rig

ht to

the

use

of ti

me

on th

e fa

cilit

ies

of a

ny b

road

cast

ing

unde

rtaki

ng o

r of a

cqui

ring

the

right

to th

e pu

blic

atio

n of

an

adve

rtise

men

t in

any

new

spap

er o

r m

agaz

ine

circ

ulat

ed i

n th

e pr

ovin

ce.

Set

out

the

nam

e an

d ad

dres

s of

eac

h br

oadc

aste

r and

pub

lishe

r, w

ith a

des

crip

tion

of th

e ad

verti

sing

, the

am

ount

pai

d to

eac

h an

d th

e co

mm

erci

al v

alue

ther

eof.

Atta

ch s

uppl

ier

docu

men

ts, b

ills

and

proo

fs o

f pay

men

t, nu

mbe

r the

m c

onse

cutiv

ely

and

list t

hem

in th

e pr

oper

col

umns

bel

ow.

Com

mer

cial

V

alue

(b)

A

mou

nt P

aid

(a)

Per

iod

for w

hich

us

ed

Pur

pose

for

whi

ch u

sed

Des

crip

tion

of

Pre

mis

es

Add

ress

Nam

e

Con

sec.

No.

Sub

tota

l

Com

mer

cial

V

alue

(b)

Am

ount

Pai

d

(a)

Dat

e of

Issu

e N

ame

of P

ublic

atio

n or

Bro

adca

ster

Add

ress

Nam

e

Con

sec.

No.

Sub

tota

l

Tota

l: (g

reat

er o

f (a)

or (

b))

Tota

l: (g

reat

er o

f (a)

or (

b))

53ELECTION FORMS


Part

II

Expe

nses

(e)

Ser

vice

s

Set

out

bel

ow th

e na

me

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny a

nd a

ssoc

iatio

n w

ho d

id w

ork

on b

ehal

f of t

he c

andi

date

, with

a d

escr

iptio

n of

the

natu

re o

f the

wor

k do

ne, t

he a

mou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue th

ereo

f. A

ttach

sup

plie

r doc

umen

ts, b

ills

and

proo

fs o

f pay

men

t, nu

mbe

r the

m

cons

ecut

ivel

y an

d lis

t the

m in

the

prop

er c

olum

ns b

elow

.

Part

II

Expe

nses

(f)

Goo

ds S

uppl

ied

Set

out

bel

ow th

e na

me

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny a

nd a

ssoc

iatio

n w

ho p

rovi

ded

good

s, w

ith a

des

crip

tion

of th

e go

ods

supp

lied,

the

amou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue th

ereo

f. A

ttach

sup

plie

r do

cum

ents

, bill

s an

d pr

oofs

of

paym

ent,

num

ber

them

con

secu

tivel

y an

d lis

t th

em in

the

prop

er c

olum

ns b

elow

.

Com

mer

cial

V

alue

(b)

Am

ount

Pai

d

(a)

Nat

ure

of W

ork

Don

e A

ddre

ssN

ame

Con

sec.

No.

Sub

tota

l

Tota

l: (g

reat

er o

f (a)

or (

b))

Com

mer

cial

V

alue

(b)

Am

ount

Pai

d

(a)

Des

crip

tion

of G

oods

Sup

plie

d(if

onl

y hi

red,

so

stat

e an

d gi

ve d

urat

ion)

A

ddre

ssN

ame

Con

sec.

No.

Sub

tota

l

Tota

l: (g

reat

er o

f (a)

or (

b))


54

E-6.01 REG 2

Part

II

Expe

nses

(g)

Trav

el a

nd H

ire o

f Veh

icle

Set

out

bel

ow a

ll tra

velli

ng e

xpen

ses

incu

rred

in c

onju

nctio

n w

ith th

e el

ectio

n, in

clud

ing

rent

al a

ccou

nts

for c

omm

erci

ally

hire

d ve

hicl

es. S

et o

ut th

e am

ount

pai

d to

eac

h an

d th

e co

mm

erci

al v

alue

ther

eof.

Atta

ch s

uppl

ier

docu

men

ts, b

ills

and

proo

fs o

f pa

ymen

t, nu

mbe

r th

em c

onse

cutiv

ely

and

list

them

in t

he

prop

er c

olum

ns b

elow

.

Part

II

Expe

nses

C

laim

s S

till U

npai

d or

Und

er th

e D

irect

ion

of th

e C

hief

Ele

ctor

al O

ffice

r or a

Jud

ge’s

Ord

er

(h)

Und

ispu

ted

Cla

ims

Unp

aid

Set

out

bel

ow th

e na

mes

and

add

ress

es o

f all

pers

ons

who

se u

ndis

pute

d cl

aim

s w

ere

rece

ived

too

late

, or r

emai

ned

unpa

id to

o lo

ng to

be

paya

ble

with

out t

he

dire

ctio

n of

the

Chi

ef E

lect

oral

Offi

cer o

r a

judg

e’s

orde

r and

in re

spec

t of w

hich

suc

h a

dire

ctio

n or

ord

er h

as b

een,

or i

s ab

out t

o be

app

lied

for,

toge

ther

with

pa

rticu

lars

of t

he n

atur

e of

the

clai

m, t

he a

mou

nt a

nd th

e co

mm

erci

al v

alue

ther

eof.

Tota

l: (g

reat

er o

f (a)

or (

b))

Com

mer

cial

V

alue

(b)

Am

ount

Pai

d

(a)

Nat

ure

of C

laim

A

ddre

ssN

ame

Con

sec.

No.

Sub

tota

l

Com

mer

cial

V

alue

(b)

Am

ount

of

Cla

im

(a)

If pa

id, d

ate

of d

irect

ion,

or

der o

r jud

gmen

t

Pai

d or

U

npai

d

Dat

eR

ecei

ved

N

atur

e of

Cla

im

Add

ress

Nam

e

Sub

tota

l

Tota

l: (g

reat

er o

f (a)

or (

b))

55ELECTION FORMS


(i)

Dis

pute

d C

laim

s U

npai

d

In a

dditi

on,

set

out

belo

w t

he d

ispu

ted

and

unpa

id c

laim

s, t

he n

ames

and

add

ress

es o

f th

e cl

aim

ants

, th

e na

ture

of

the

clai

ms

resp

ectiv

ely,

the

am

ount

and

c o

mm

erci

al v

alue

ther

eof.

Com

mer

cial

V

alue

(b)

Am

ount

of

Cla

im

(a)

Cha

ract

er o

f Dis

pute

d C

laim

A

ddre

ssN

ame

Sub

tota

l

Tota

l: (g

reat

er o

f (a)

or (

b))


56

E-6.01 REG 2

Statement of Contribution Corporation, Trust Fund or Constituency Association

Contributor Name of Corporation, Trust Fund or Constituency Association

Address

Postal Code

Telephone Number ( )

I, the undersigned,

having authorization to act for the , Name of Corporation, Trust Fund or Constituency Association

submit the following statement of the individual sources and amounts making up the contribution (or the

fund) of this corporation, trust fund or constituency association, and further that the total amount indicated is

the amount contributed to Name of Candidate

a candidate at the election about to be held in the constituency of .

nosreP dezirohtuA fo erutangiS etaD

dleH noitisoP

I, the undersigned, business manager for Name of Candidate

certify that the following record of contributions is a true and correct copy of the statement of contribution

received by the above-named contributor pursuant to The Election Act, 1996 (subsection 240(6)).

reganaM ssenisuB fo erutangiS

57ELECTION FORMS


Sources and Amounts

(Check one) This is a record of individual sources and amounts making up the contribution.

This is a record of individual sources and amounts making up the fund.


Note: List below, the aggregate value of contributions received in a year from any person who contributed in excess of $250.00 whose funds were used toward the making of this contribution.


List additional contributors on separate sheet provided and affix to this record.


snoitubirtnoC )A( yrogetaC lla fo tnuomA latoT

(B) Contributions of $250.00 or less

Note: Report the total value of contributions received in a year from any person who contributed $250.00 or less whose funds were used toward the making of this contribution.

snoitubirtnoC )B( yrogetaC lla fo tnuomA latoT

(C) Interest or Investment Income

Note: Report the total value of interest or investment income received in a year which was used toward the making of this contribution.

snoitubirtnoC )C( yrogetaC lla fo tnuomA latoT

Total Contributions


Enter Totals under applicable Schedule of Part 1(b) Detail of Contributions


58

E-6.01 REG 2

Statement of Contribution Registered Party

Contributor Name of Registered Party

Address

Postal Code

Telephone Number ( )

The following is a statement of the individual sources and amounts making up the contribution of this registered party, and further that the total amount indicated is the amount contributed to

, Name of Candidate

a candidate at the election about to be held in the constituency of .

etaD

I, the undersigned, business manager for Name of Candidate

certify that the following record of contributions is a true and correct copy of the statement of contribution received by the above-named contributor pursuant to The Election Act, 1996 (subsection 240(7)).

Signature of Business Manager

59ELECTION FORMS


17 Feb 2006 SR 6/2006 s4.

Sources and Amounts


Note: List below, the aggregate value of contributions received in a year from any person who contributed in excess of $250.00 whose funds were used toward the making of this contribution.




snoitubirtnoC )A( yrogetaC lla fo tnuomA latoT


Note: Report the total value of contributions received in a year from any person who contributed $250.00 or less whose funds were used toward the making of this contribution.

snoitubirtnoC )B( yrogetaC lla fo tnuomA latoT

Total Contributions

(Sum of Categories (A) and (B))

Enter Total on Schedule: 4. Unincorporated Organizations or Associations of snoitubirtnoC fo liateD )b(1 traP


60

E-6.01 REG 2

FORM WW[Clause 261(1)(c) of the Act]

Oath or Declaration of Business Manager of a Candidate

I ________________________________________________ of ________________________________________________ ,being the business manager of ______________________________________________________________, a candidateat the election held on the _____________ day of ________________________ , ____________ of a member of theLegislative Assembly of Saskatchewan,

solemnly declare that I have examined the Return of Election Expenses, along with any attached certifiedstatements, to be transmitted to the Returning Officer at that election and now shown to me by the officer beforewhom this declaration is made, and that to the best of my knowledge and belief that return and any attachedcertified statements are correct;

and I further solemnly declare that, except as appears from that Return, I have not and to the best of my knowledgeand belief no other person, nor any club, society, company or association has on behalf of the candidate made anypayment, or given, promised or offered any reward, office, employment or valuable consideration, or incurred anyliability on account of or with respect to the conduct or management of the election;

and I further solemnly declare that I have received from the candidate, the sum of (insert NO if the fact is so)

_______________ dollars and no more for the purposes of the election, and that, except as specified in the Returnmade by me, no money, security or equivalent for money has been paid, advanced, given or deposited by anyone tome or in my hands, or to the best of my knowledge and belief, to or in the hands of any other person for the purposeof defraying any expenses incurred on behalf of the candidate on account of or with respect to the conduct ormanagement of the election;

and I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same forceand effect as if made under oath, and by virtue of the Canada Evidence Act.

____________________________________________________Signature of Business Manager

Signed and declared before me by the above-named business manager at ___________________________________in the Province of Saskatchewan, on the ____________ day of __________________ , ___________ .

____________________________________________________Person Authorized to Administer Oaths inSaskatchewan

2 Jan 1998 cE-6.01 Reg 2.

61ELECTION FORMS


FORM XX[Subsection 261(5) of the Act]

Candidate’s Oath or Declaration as to Expenses

I, ____________________________________________________________________________________________ , whoseaddress is __________________________________________________________________________________ and whoseoccupation is ____________________________________________________ , having been a candidate at the electionof a member to serve in the Legislative Assembly of Saskatchewan for the constituency of ___________________ ,held on the _____________________ day of _______________________ , _________ , solemnly declare that I have

(insert date of poll)

examined the Return of Election Expenses, along with any certified statements, transmitted or about to betransmitted by my business manager to the Returning Officer at the election, a copy of which Return is nowshown by me and signed by the officer before whom this declaration is made, and that to the best of my knowledgeand belief that Return and any attached certified statements are correct;

and I further solemnly declare that, except as appears from that Return, I have not, and to the best of my knowledgeand belief no person, nor any club, society, company or association has, on my behalf, made any payment, or given,promised or offered any reward, office, employment or valuable consideration, or incurred any liability on accountof or with respect to the conduct or management of the election;

and I further solemnly declare that I have paid to my business manager, the sum of (insert NO if the fact is so)

_________________ dollars and no more for the purpose of the election, and that, except as specified in the Return,no money, security or equivalent for money has to my knowledge or belief been paid, advanced, given or depositedby anyone to or in the hands of my business manager or any other person for the purpose of defraying anyexpenses incurred on my behalf on account of or with respect to the conduct or management of the election;

and I further solemnly declare that I will not, except so far as I may be permitted by law, at any future time makeor be party to the making or giving of any payment, reward, office employment or valuable consideration for thepurpose of defraying any such expenses as last mentioned, or provide or be party to the providing of any money,security or equivalent for the purpose of defraying any such expenses;


____________________________________________________Signature of Candidate

Signed and declared before me by the above-named candidate at ___________________________________________in the Province of Saskatchewan, on the ____________ day of ________________________ , _________ .


2 Jan 1998 cE-6.01 Reg 2.


62

E-6.01 REG 2

(Those categories of payments that arereported as not being made shall be omittedfrom the advertisement)

FORM YY[Subsection 261(8) of the Act]

Summary of Candidate Election Expenses

Constituency of ________________________________________________________________________________________

I, _____________________________________________ of ____________________________________________________(Name of Returning Officer () Residential Address)

in the Province of Saskatchewan, Returning Officer for the Constituency of ________________________________ ,set out below a summary of the election expenses incurred by ______________________________________________

(Name of Candidate)being (a representative of ___________________________________________________________________ and a) (or in

(Name of Registered Political Party)the case of an independent candidate insert (an Independent)) candidate at the election of a member to serve inthe Legislative Assembly of Saskatchewan held on ________________________________________ ,_____________ .

(Date of Poll)The sums stated are taken from the above-named Candidate’s Return of Election Expenses received by me on___________________________________ , __________ . Any voter wishing to do so may examine the above-namedcandidate’s complete return of election expenses, a copy of which shall remain in my possession for a period of sixmonths ending on __________________ , _________ .

AmountReceipts

Receipts, loans, contributions,donation of goods and services,proceeds from fund-raising events and saleof tickets, pins, buttons, etc.

PaymentsCandidate’s Personal Expenses

Candidate’s Campaign Expenses

Petty Expenses

Hire of Premises

Advertising

Services

Goods Supplied

Travel and Hire of Vehicles

Undisputed Claims Unpaid

Disputed Claims Still Unpaid

Dated at ______________ , Saskatchewan, this ___________ day of __________________ , ___________ .

_____________________________________________________Returning Officer

2 Jan 1998 cE-6.01 Reg 2.

63ELECTION FORMS


FORM ZZ[Section 251 of the Act]

Registered Political Party’sReturn of Election Expenses

On Behalf of

_______________________________________________________________________________________________________Name of Registered Political Party

Return

I, _______________________________________________ of __________________________________________________sserddAemaN

_______________________________________________________________________________________________________Mailing Address (if different from the residential address)

Telephone Number Residence ( ) ________________________ Business ( ) ______________________

in the Province of Saskatchewan, being the chief official agent of the above-named registered political party, makethe following Return respecting the election expenses of the said party, which were incurred during the electionheld on the ____________ day of __________________ , _______ .

___________________________________________________Signature of Chief Official Agent

___________________________________________________Date

Note

1. This Return must be transmitted to the Chief Electoral Officer within six (6) months after polling day at theelection to which it relates.Subsection 251(1)

2. This Return must be accompanied by the auditor’s report to the chief official agent of the party on theinformation given in this Return.Subsection 251(1)

3. The commercial value of goods and services donated (other than volunteer labour or goods valued at $25.00 orless), and the difference between the amount paid and the commercial value of goods and services provided, areconsidered to be election expenses. If the total of “commercial value” is greater than the total of “amount paid” itis the larger of the two figures that is used in the calculation of election expenses incurred by the registeredpolitical party. See definition of “commercial value”, subsection 220(c).

4. A statement, signed and receipted, by the donor and by the chief official agent, supported by a verificationfrom an independent commercial source of the amount expensed must be submitted when making claim ofcommercial value as an election expense.Subsections 220(c) and 251(2)(b)

5. All payments of more than $25.00 must be accompanied by a supplier document that states the particulars ofthe election expense and by a receipt or cancelled cheque that provides proof of payment. The supplier documentsand proofs of payment must be submitted with this Return.Section 244Subsection 251(2)(b)


64

E-6.01 REG 2

Summary of Election Expenses

_______________$sesnepxE ytteP)a(

_______________$sesimerP fo eriH)b(

_______________$gnisitrevdA)c(

_______________$secivreS)d(

_______________$deilppuS sdooG)e(

(f) Travel and Hire of Vehicle $ _______________

(g) Undisputed Claims Unpaid $ _______________

____________$SESNEPXE LATOT

(h) Disputed Claims Unpaid $ _______________

Note: Total Expenses (excluding (g) above) is used for the calculation of reimbursement.

Expenses

(a) Petty Expenses

Set out below the petty expenses paid under the authority of the chief official agent pursuant to section 248. Attachand number consecutively, the statement(s) of particulars of the amounts expensed supported by supplieddocuments, bills and proofs of payment.

diaP tnuomAsralucitraP.oN .cesnoC

Total

65ELECTION FORMS


Exp

ense

s

(b)

Hir

e of

Pre

mis

es

Set

out

bel

ow t

he n

ame

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny a

nd a

ssoc

iati

on f

rom

who

m p

rem

ises

wer

e ac

quir

ed f

or t

he p

urpo

se o

f th

eel

ecti

on, w

ith

a de

scri

ptio

n of

the

pre

mis

es s

o ac

quir

ed, t

he p

urpo

se fo

r w

hich

and

the

leng

th o

f tim

e du

ring

whi

ch t

he s

ame

wer

e us

ed, t

he a

mou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue th

ereo

f. A

ttac

h su

ppli

er d

ocum

ents

, bil

ls a

nd p

roof

s of

pay

men

t, n

umbe

r th

em c

onse

cuti

vely

an

d li

st th

em in

the

prop

erco

lum

ns b

elow

.

laicrem

moC

tnuom

Arof doire

Prof esopru

Pfo noitpircse

D.cesno

C No.

Nam

eA

ddre

ss P

rem

ises

whi

ch u

sed

whi

ch u

sed

Pai

d

Val

ue

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))

Exp

ense

s

(c)

Adv

erti

sing

Set

out

bel

ow th

e co

st o

f acq

uiri

ng th

e ri

ght t

o th

e us

e of

tim

e on

the

faci

liti

es o

f any

bro

adca

stin

g un

dert

akin

g or

of a

cqui

ring

the

righ

t to

the

publ

icat

ion

of a

n ad

vert

isem

ent

in a

ny n

ewsp

aper

or

mag

azin

e ci

rcul

ated

in t

he p

rovi

nce.

Set

out

the

nam

e an

d ad

dres

s of

eac

h br

oadc

aste

r an

d pu

blis

her,

wit

h a

desc

ript

ion

of t

he a

dver

tisi

ng, t

he a

mou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue t

here

of.

Att

ach

supp

lier

doc

umen

ts, b

ills

and

pro

ofs

of p

aym

ent,

num

ber

them

con

secu

tive

ly a

nd li

st t

hem

in t

he p

rope

r co

lum

ns b

elow

.

laicrem

moC

tnuom

Afo eta

Dnoitacilbu

P fo ema

N.cesno

C

N

o.N

ame

Add

ress

or

Bro

adca

ster

Iss

ue P

aid

V

alue

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))


66

E-6.01 REG 2

Exp

ense

s

(d)

Ser

vice

s

Set

out

bel

ow t

he n

ame

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny a

nd a

ssoc

iati

on w

ho d

id w

ork

on b

ehal

f of t

he r

egis

tere

d po

liti

cal p

arty

, wit

ha

desc

ript

ion

of t

he n

atur

e of

the

wor

k do

ne, t

he a

mou

nt p

aid

to e

ach

and

the

com

mer

cial

val

ue t

here

of.

Att

ach

supp

lier

doc

umen

ts, b

ills

and

pro

ofs

o fpa

ymen

t, nu

mbe

r th

em c

onse

cuti

vely

and

list

the

m in

the

pro

per

colu

mns

bel

ow.

Con

sec.

Am

ount

Com

mer

cial

eulaV

diaP eno

D kroW fo eruta

Nsserdd

Ae

maN

.oN

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))

Exp

ense

s

(e)

Goo

ds S

uppl

ied

Set

out

bel

ow th

e na

me

and

addr

ess

of e

very

per

son,

clu

b, s

ocie

ty, c

ompa

ny o

r as

soci

atio

n w

ho p

rovi

ded

good

s, w

ith

a de

scri

ptio

n of

the

good

s su

ppli

ed, t

heam

ount

pai

d to

eac

h an

d th

e co

mm

erci

al v

alue

ther

eof.

Att

ach

supp

lier

doc

umen

ts, b

ills

and

pro

ofs

of p

aym

ent,

num

ber

them

con

secu

tive

ly a

nd li

st th

emin

the

pro

per

colu

mns

bel

ow.

laicrem

moC

tnuom

Adeilppu

S sdooG fo noitpircse

D.cesno

Ceula

V dia

P )noitarud evig dna etats os ,derih ylno fi(

sserddA

ema

N.o

N

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))

67ELECTION FORMS


Exp

ense

s

(f)

Tra

vel a

nd H

ire

of V

ehic

le

Set

out

bel

ow a

ll t

rave

llin

g ex

pens

es i

ncur

red

in c

onju

ncti

on w

ith

the

elec

tion

, inc

ludi

ng r

enta

l ac

coun

ts f

or c

omm

erci

ally

hir

ed v

ehic

les.

S

et o

ut t

heam

ount

pai

d to

eac

h an

d th

e co

mm

erci

al v

alue

ther

eof.

Att

ach

supp

lier

doc

umen

ts, b

ills

and

pro

ofs

of p

aym

ent,

num

ber

them

con

secu

tive

ly a

nd li

st th

emin

the

pro

per

colu

mns

bel

ow.

Con

sec.

Am

ount

Com

mer

cial

eulaV dia

P mial

C fo erutaN

sserddA

ema

N.o

N

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))

Exp

ense

s

Cla

ims

Sti

ll U

npai

d or

Und

er t

he D

irec

tion

of t

he C

hief

Ele

ctor

al O

ffic

er o

r a

Judg

e’s

Ord

er

(g)

Und

ispu

ted

Cla

ims

Unp

aid

Set

out

bel

ow t

he n

ames

and

add

ress

es o

f all

per

sons

who

se u

ndis

pute

d cl

aim

s w

ere

rece

ived

too

late

, or

rem

aine

d un

paid

too

lon

g to

be

paya

ble

wit

hout

the

dire

ctio

n of

the

Chi

ef E

lect

oral

Off

icer

or

a ju

dge’

s or

der

and

in r

espe

ct o

f w

hich

suc

h a

dire

ctio

n or

ord

er h

as b

een,

or

is a

bout

to

be a

ppli

ed f

or,

toge

ther

wit

h p

arti

cula

rs o

f the

nat

ure

of t

he c

laim

, the

am

ount

and

the

com

mer

cial

val

ue t

here

of.

Dat

e

Pa

idIf

pai

d, d

ate

of d

irec

tion

,A

mou

nt o

fC

omm

erci

alN

ame

Add

ress

Nat

ure

of C

laim

Rec

eive

dor

Upd

aid

or

der

or ju

dgm

ent

C

laim

V

alue

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))


68

E-6.01 REG 2

(h)

Dis

pute

d C

laim

s U

npai

d

In a

ddit

ion,

set

out

bel

ow t

he d

ispu

ted

and

unpa

id c

laim

s, t

he n

ames

and

add

ress

es o

f the

cla

iman

ts, t

he n

atur

e of

the

cla

ims

resp

ecti

vely

, the

am

ount

and

com

mer

cial

val

ue t

here

of.

Am

ount

of

Com

mer

cial

fo retcarahC

sserddA

ema

ND

ispu

ted

Cla

im C

laim

V

alue

Sub

tota

l(a

)(b

)

Tota

l:(g

reat

er o

f (a)

or

(b))

2 Jan 1998 cE-6.01 Reg 2.

69ELECTION FORMS


FORM AAA[Clause 251(1)(c) of the Act]

Oath or Declaration of a Chief Official Agent of aRegistered Political Party

I, __________________________________________________ of _______________________________________________ ,being Chief Official Agent of _________________________________________________________ , being a registeredpolitical party, operating during an election held in Saskatchewan on the ___________________________ day of__________________________ , ____________ ,

solemnly declare that I have examined the Return of Election Expenses to be transmitted to the Chief ElectoralOfficer, and now shown to me by the officer before whom this declaration is made, and that to the best of myknowledge and belief that Return is correct;

and I further solemnly declare that except as appears from that Return, I have not and to the best of my knowl-edge and belief no other person, nor any club, society, company or association has on behalf of the registeredpolitical party made any payment, or given, promised or offered any reward, office, employment or valuableconsideration, or incurred any liability on account of or with respect to the conduct or management of the election;


____________________________________________________Signature of Chief Official Agent

Signed and declared before me by the above-named Chief Official Agent at __________________________________in the Province of Saskatchewan, on the __________ day of _____________________ , _________ .


2 Jan 1998 cE-6.01 Reg 2.


70

E-6.01 REG 2

FORM BBB[Section 250 of the Act]

Registered Political Party’sFiscal Period Return

On Behalf of the

_______________________________________________________________________________________________________Name of Registered Political Party

Return

I, ______________________________________________ of ___________________________________________________sserddAemaN

_______________________________________________________________________________________________________Mailing Address (if different from the residential address)

Telephone Number Residence ( ) ______________________ Business ( ) ____________________

in the Province of Saskatchewan, being the chief official agent of the above-named registered political partymake the following Return respecting the fiscal period of the party which commenced on the ________________day of ____________________________ , ___________ , and which terminated on the __________________ day of__________________________________ , ___________ .

_______________________________________ ______________________________________________________Signature of Chief Official Agent Date

Note

1. This Return must be transmitted to the Chief Electoral Officer within four (4) months after the end of thefiscal period to which it relates.Subsection 250(4)

2. This Return must be accompanied by the auditor’s report to the chief official agent of the party on theinformation given in this Return.Subsection 250(4)

3. The value of goods and services provided is the “Commercial Value” as defined in subsection 220(c).

71ELECTION FORMS


Part I

Contributions

(a) Summary of Contributions

List below, by class of contributor, the aggregate amounts of (A) contributions in excess of $250.00, (B) contributionsof $250.00 or less but more than $25.00, and (C) contributions of $25.00 or less, and the number of contributorsof each class who, in the fiscal period, have provided money, goods or services for the use of the registeredpolitical party by way of a gift, loan, advance, deposit, or other form of assistance (includes goods or servicesdonated or provided at other than their true value).

Number of Value ofsnoitubirtnoCsrotubirtnoCrotubirtnoC fo ssalC

1. Individuals

2. Corporations

3. Trade Unions

4. Unincorporated Organizations or Associations

5. Any other Persons or Groups of Persons

Totals

Note: Amounts received in respect of membership fees or dues are deemed to be contributions (s. 250(5)).

Part I

Contributions

(b) Detail of Contributions

Contributions include money provided to or on behalf of the registered political party without compensation fromthe registered political party and includes donations in kind and membership fees or dues paid to the registeredpolitical party.

Detail of the name of and total amount received from each contributor included in classes 1 to 5 in Part (a) whohave provided money, goods or services by way of a gift, loan, advance, deposit or other form of assistance mustbe reported in the aggregate by classification in the appropriate schedule. Such contributions are to be identifiedin one of three categories: (A) contributions in excess of $250.00, (B) contributions of $250.00 or less but morethan $25.00, and (C) contributions of $25.00 or less. The sum of the categories should reflect the total contributionsreceived, in the fiscal period, for the use of the registered political party in each classification schedule.

Where a corporation, trust fund or constituency association of a registered political party makes a contribution,pursuant to Section 240(6) of The Election Act, 1996, each such contribution must be accompanied by a statementwhich sets out the name of the person who authorized the contribution on behalf of the corporation, trust fund orconstituency association, and the name of and the amount contributed by, each person who made a contributionin excess of $250.00 in a year and whose contribution was used to make up the funds contributed by the corporation,trust fund or constituency association.

Where a registered party makes a contribution, pursuant to Section 240(7) of The Election Act, 1996, each suchcontribution must be accompanied by a statement which sets out the name of and the amount contributed by,each person who made a contribution in excess of $250.00 in a year and whose contribution was used to make upthe funds contributed by the registered party.

A true and correct copy, certified by the chief official agent, for each such statement of contribution receivedpursuant to subsections 240(6) and (7), must be affixed to this Return (s.250(3)).

Revenue received by a registered political party, during the fiscal period, from fund-raising activities, meetingsand sales of material of a promotional nature are deemed contributions. The total net proceeds from each sourceindicated must be recorded and, in the aggregate, reported in this Return.

The value of donations in kind must be recorded and included as a contribution received by the chief officialagent where claimed as an election expense. Accordingly, commercial value is an election expense and a contributionconcurrently.


72

E-6.01 REG 2

Schedule: 1. Individuals


Note: List below, all contributions where during the fiscal period the aggregate value of contributions exceeded$250.00.

tnuomArotubirtnoC fo emaN


List Attached ___________________ Number of Pages _______________Yes or No

____________srotubirtnoC fo rebmuN

Total Amount ______________________snoitubirtnoC )A( yrogetaC lla fo


Note: Report the number of contributors and the total value ofcontributions received, during the fiscal period from anyindividual, of $250.00 or less but more than $25.00.


______________________snoitubirtnoC )B( yrogetaC lla fo tnuomA latoT


Note: Report the number of contributors and thetotal value of contributions received during thefiscal period, from any individual, of $25.00 or less.


______________________snoitubirtnoC )C( yrogetaC lla fo tnuomA latoT

Total Number of Contributors

Total Contributions


Enter Totals on Part 1(a) Summary of ContributionsLine 1.

73ELECTION FORMS


Schedule: 2. Corporations









Note: Report the number of contributors and thetotal value of contributions received duringthe fiscal period, from any corporation,of $250.00 or less but more than $25.00.




Note: Report the number of contributors and thetotal value of contributions received duringthe fiscal period, from any corporation, of$25.00 or less.




Total Contributions




74

E-6.01 REG 2

Schedule: 3. Trade Unions









Note: Report the number of contributors and thetotal value of contributions received during thefiscal period, from any trade union, of $250.00or less but more than $25.00.




Note: Report the number of contributors and thetotal value of contributions received during thefiscal period, from any trade union, of $25.00 or less.




Total Contributions



75ELECTION FORMS


Schedule: 4. Unincorporated Organizations and Associations


Note: List below, all contributions where during the fiscal period the aggregate value of contributions exceeds$250.00.







Note: Report the number of contributors and thetotal value of contributions received during the fiscalperiod, from any unincorporated organization orassociation, of $250.00 or less but more than $25.00.




Note: Report the number of contributors and the total valueof contributions received during the fiscal period, fromany unincorporated organization or association,of $25.00 or less.




Total Contributions




76

E-6.01 REG 2

Schedule: 5. Any other Persons or Groups of Persons









Note: Report the number of contributors and the total valueof contributions received during the fiscal period, fromany other persons or groups of persons, of $250.00 orless but more than $25.00.




Note: Report the number of contributors and the total valueof contributions received during the fiscal period, fromany other persons or groups of persons, of $25.00 or less.




Total Contributions



77ELECTION FORMS


Part I

Contributions

(c) Proceeds from Other Sources – Summary

Set out below the aggregate value of net proceeds received by the registered political party during the fiscalperiod from the sources as indicated.

tnuomAecruoS

1. Sales of tickets to or monies paid to each dinner, rally,public meeting and other fund-raising function.

2. Collections made at events mentioned in item 1 above or otherevents.

3. Sales of pins, buttons, flags, emblems, hats, banners, literatureand other materials.

Total

Enter Total on Schedule: 5. Any other Persons or Groups of Persons of Part 1(b) Detail of Contributions

Part I

Other Revenue

(a) Income from Other Sources

Set out below the total value of income received by the registered political party during the fiscal period from thesources as indicated.

tnuomAecruoS

1. Election Expenses/Auditor Reimbursement(s)

2. Candidates’ Excess Contributions

3. Interest/Investment Income

4. Other (Provide Details)

Total

(b) Cash on Hand

Set out the amount of money, securities or the equivalent of money thatthe registered political party has on hand at the end of the fiscal period.


78

E-6.01 REG 2

Part II

Expenditures

(a) Operating Expenditures

Set out below the total operating expenses of the registered political party during the fiscal period.

Note: Omit election expenses incurred which related to an election held during the fiscal period.

tnuomAsesnepxE gnitarepO

1. Salaries, Wages and Employee Benefits

2. Travelling Expenses

3. Conventions and Meetings

4. Rental (Premises, Equipment and Utilities)

5. Advertising (Particulars to be set out in Part II(b))

6. Printing, Stationery and Supplies

7. Postage

8. Legal and Audit Fees

9. Interest

10. Taxes (Property)

11. Other (Provide Details)

Total

Part II

Expenditures

(b) Advertising Expenditures

Set out below the particulars of expenditures on advertising of the registered political party during the fiscalperiod.

Note: Subsection 243(4) limits the amount of money a registered party can spend during a fiscal period onadvertising. This limit does not apply to election expenses which may be lawfully incurred by a registeredpolitical party.

Name of Broadcaster or Publisher Date of Advertisement Amount

Total

79ELECTION FORMS


Part II

Expenditures

(c) All Other Expenditures

Set out below any transfer of monies or other expenses incurred by the registered political party during thefiscal period.

tnuomAserutidnepxE rehtO

1. Transfer to Provincial Constituencies and Candidates

2. Transfer to Federal Electoral District

3. Transfer to Registered Party

4.

5.

6.

7.

8.

9.

Total

Statement of ContributionRegistered Party

Contributor ___________________________________________________________________________________________Name of Registered Party

Address _______________________________________________________________________________________________

_______________________________________________________________________________________________________Postal Code

Telephone Number ( ) ________________________

The following is a statement of the individual sources and amounts making up the contribution of this registeredparty, and further that the total amount indicated is the amount contributed to the ________________________ ,a registered political party in the Province of Saskatchewan.

___________________________________Date

I, the undersigned, chief official agent of the _____________________________________________________________Name of Registered Political Party

certify that the following record of contributions is a true and correct copy of the statement of contributionreceived by the above-named contributor pursuant to The Election Act, 1996 (s. 240(7)).

______________________________________________________Signature of Chief Official Agent


80

E-6.01 REG 2

Sources and Amounts


Note: List below, the aggregate value of contributions received in a year from those who contributed in excess of$250.00 whose funds were used toward the making of this contribution.




______________________snoitubirtnoC )A( yrogetaC fo tnuomA latoT


Note: Report the total value of contributions received in a yearfrom those who contributed $250.00 or less whose fundswere used toward the making of this contribution.

______________________snoitubirtnoC )B( yrogetaC fo tnuomA latoT

Total Contribution

(Sum of Categories (A) and (B))

Enter Total on Schedule: 4. Unincorporated Organizationsor Associations of Part 1(b) Detail of Contributions

81ELECTION FORMS


Statement of ContributionCorporation, Trust Fund or Constituency Association

Contributor __________________________________________________________________________________________ Name of Corporation, Trust Fund or Constituency Association of a Registered Political Party

Address ______________________________________________________________________________________________

______________________________________________________________________________________________________Postal Code

Telephone Number ( ) _____________________

I, the undersigned, having authorization to act for the

_____________________________________________________________________________________________________ ,Name of Corporation, Trust Fund or Constituency Association of a Registered Political Party

submit the following statement of the individual sources and amounts making up the contribution (or the fund)of this corporation, trust fund or constituency association, and further that the total amount indicated is theamount contributed to the ____________________________________________________________________________ ,a registered political party in the Province of Saskatchewan.

______________________________________ _____________________________________________________Date Signature of Authorized Person

_____________________________________________________Position Held

I, the undersigned, chief official agent of the ____________________________________________________________Name of Registered Political Party

certify that the following record of contributions is a true and correct copy of the statement of contributionreceived by the above-named contributor pursuant to The Election Act, 1996 (s. 240(6)).

_____________________________________________________Signature of Chief Official Agent


82

E-6.01 REG 2

Sources and Amounts

(Check one) This is a record of individual sources and amounts making up the contribution.This is a record of individual sources and amounts making up the fund.


Note: List below, the aggregate value of contributions received in a year from those who contributed in excess of$250.00 whose funds were used toward the making of this contribution.




______________________snoitubirtnoC )A( yrogetaC fo tnuomA latoT


Note: Report the total value of contributions received in a yearfrom those who contributed $250.00 or less whose fundswere used toward the making of this contribution.

______________________snoitubirtnoC )B( yrogetaC fo tnuomA latoT

(C) Interest or Investment Income

Note: Report the total value of interest or investment incomereceived in a year which was used toward the makingof this contribution.

______________________snoitubirtnoC )C( yrogetaC fo tnuomA latoT

Total Contribution


Enter Total under applicable Schedule of Part 1(b)Detail of Contributions

2 Jan 1998 cE-6.01 Reg 2.

83ELECTION FORMS


FORM CCC[Section 279 of the Act]

Statement Respecting Election Programs,Advertisements and Announcements

I, ______________________________________________________________ , a broadcaster, licensee of a broadcastingundertaking or publisher of a newspaper, magazine or periodical,certify that the statement set out below respectingelection programs, advertisements and announcements broadcast or published with respect to the registeredpolitical party or candidate named below in relation to the election held on __________________________________is true and accurate.

Registered Political Party (or) Candidate Amount Charged Nature of Program,(or) Person (or) Association Making Payment for Broadcast Advertisement, orfor Program, Advertisement or Announcement or Publication Announcement

Name Address

Dated at _____________ , Saskatchewan , this ________ day of _______________ , __________ .

____________________________________________________Signature of Officer in Charge (or) Publisher

_____________________________________________________Name of Broadcast Undertaking, Licenseeof Broadcast Undertaking (or) Publication

____________________________________________________Business Address

2 Jan 1998 cE-6.01 Reg 2.

FORM DDD[Subsection 252(3) of the Act]

Certificate of the Returning Officer(Number of Voters on Official Voters’ List)

Constituency of ______________________________________________________________________________________

I, ____________________________________ , the undersigned Returning Officer for the above-named constituency,certify that the number of voters whose names appear on the official voters’ list for all polling divisions in thisconstituency as enumerated, revised and corrected pursuant to section 28 of The Election Act, 1996 for the electionheld in this constituency on the ____________________ day of _________________________________ , _________ ,is ________________________________________ .

_____________________________________________________Signature of Returning Officer

2 Jan 1998 cE-6.01 Reg 2.


84

E-6.01 REG 2

FORM EEE[Section 5 of the Act]

Poll Book

31 Oct 2014 SR 85/2014 s5.

85ELECTION FORMS


2 Jan 98 cE-6.01 Reg 2.

Form FFF[Section 250 of the Act]

Oath or Declaration of a Chief Official Agentof a Registered Political Party

I, _______________________________________________ of _________________________________________________ ,Chief Official Agent of ______________________________________________________ , a registered political party,

solemnly declare that I have examined the Fiscal Period Return, along with any attached certified statements tobe transmitted to the Chief Electoral Officer and now shown to me by the officer before whom this declaration ismade, and that, to the best of my knowledge and belief, that Return and any attached certified statements arecorrect;

and I further solemnly declare that, except as specified in the Return, no money, security, or equivalent for moneyhas been paid, advanced, given or deposited by anyone to me or, to the best of my knowledge and belief, to anyother person for the purpose of defraying any expenses incurred on behalf of the registered political party or forpromoting its aims;

and I further solemnly declare that, except as appears from that Return, I have not, and, to the best of myknowledge and belief, no person, club, society, company or association has, on behalf of the registered politicalparty, made any payment or incurred any liability on account of or with respect to the conduct or management ofthe affairs of the registered political party;


______________________________________________________Signature of Chief Official Agent

Signed and declared before me by the above-named Chief Official Agent at ___________________________ in theProvince of Saskatchewan, on the ____________ day of ________________________ , __________ .

______________________________________________________Person Authorized to Administer Oaths in Saskatchewan


86

E-6.01 REG 2

FORM GGG [Section 5 of the Act]

Consecutive Number

1

Name of Voter

2

Address of Voter (Street and Number or Land Location)

3

Occupation

4

Polling Division Number

5

Number on Voters’ List

6

Date Absentee Voter Application Received

7

Date Absentee Ballot Kit was forwarded

8

Address where Absentee Ballot Kit was forwarded (If different from Column 3)

9

Outer Envelope Received Outside of Deadline

10

Certificate Envelope Rejected by Returning Officer

11

Certificate Envelope Deposited in Sealed Ballot Box

enter a checkmark w

here applicable

12

Remarks

13

17 Feb 2006 SR 6/2006 s4.

87ELECTION FORMS


FORM HHH [Section 224 of the Act]

Application to Chief Electoral Officer for Registration of a Political Party

I hereby apply to have registered, pursuant to section 224, of The Election Act, 1996, the political party named herein:

A. the full name of the political party is ;

B. the name of the political party and any abbreviation of that name that is to be shown in any election documents is ;

C. the name and address of the leader of the political party is

Name ;

Address Postal Code

D. the address of the office of the political party where records are maintained and where notices, documents and other communications pursuant to the Act may be delivered is

; Address Postal Code

E. the names and addresses of the officers of the political party are affixed, or

(i) sserddA emaN

edoC latsoP dleH eciffO

(ii) sserddA emaN

edoC latsoP dleH eciffO

(iii) sserddA emaN

; edoC latsoP dleH eciffO

F. the name and address of the chief official agent of the party is

Name ;

Address Postal Code

G. the name and address of the auditor of the party is

Name .

Address Postal Code

Attached hereto is an audited financial statement of the political party, including a statement of assets and liabilities, as ata date not more than 60 days prior to the date of this application, namely:

, 20 . tiduA fo etaD

The primary purpose of the political party is to field candidates for election as Members of the Legislative Assembly of Saskatchewan.

redaeL ytraP fo erutangiS


17 Feb 2006 SR 6/2006 s4.


88

E-6.01 REG 2

31 Oct 2014 SR 85/2015 s5.

FORM III[Subsection 89.2(1) of the Act]

Homebound Voter Application and Declaration

To: The Returning Officer, Constituency of

Part 1 Application (eligible voter who is disabled or caregiver of an eligible voter who is disabled)

I hereby apply to vote at the election now pending as provided in sections 89.1, 89.2, and 89.3, inclusive, of The Election Act, 1996.

)”htimS“ ,.g.e( emaN tsaL)”A“ ro ”ecilA“ ,.g.e( laitinI ro emaN elddiM)”yraM“ ,.g.e( emaN tsriF

G Male G Female Date of Birth (yyyy/mm/dd) (e.g., 1960/12/23) Occupation (e.g., labourer)

I am (check one):

G An eligible voter who is disabled

G Caregiver of an eligible voter who is disabled

Ordinary Residential Address (on the day the writ was issued)

Number & Street (e.g., 123 Main Street) Apartment/Unit (e.g., Apt. 4 or Unit 4) or Land Location (e.g., NE20-16-10 W3M)

, Saskatchewan City, Town or Village (e.g., Ile-a-la-Crosse) Postal Code (e.g., S4N 6B2)

Telephone: ( ) / Cell: ( )

Facsimile: ( ) / Email Address:

Part 2 Declaration of Voter ! I am the full age of 18 years or will attain the full age of 18 years on or before Polling Day;! I am a Canadian citizen or a British subject and was qualified as a voter on June 23, 1971;! I have ordinarily resided in Saskatchewan for at least six months immediately preceding the day the writ

was issued;! I was ordinarily resident in the above-mentioned constituency on the day the writ was issued; ! I am not disqualified pursuant to section 17 of The Election Act, 1996 to vote at this election; ! I am unable to vote at an Advance Poll or on Polling Day in the constituency in which I am an ordinary

resident due to a disability or I am providing care to a person with a disability and unable to vote at anAdvance Poll or on Polling Day in the constituency in which I ordinarily reside; and

! I have not already voted at this election.

I make this solemn declaration conscientiously, believing it to be true and knowing that it is of the same forceand effect as if made under oath and by virtue of the Canada Evidence Act.

Signature of Applicant Date

89ELECTION FORMS


FORM JJJ[Clause 89.3(4)(c) of the Act]

Certificate Envelope

To be completed by the Returning Officer:

Constituency of

ofName of Voter

Address (Street and Number) and (apt. or unit) or Land Location

, Saskatchewan City, Town or Village Postal Code

To be completed by the homebound voter:

Insert ballot envelope (E-163) in this envelope, seal and complete the followingcertificate.

I certify that I am entitled to vote pursuant to section 89.1 of The Election Act,1996, because I am unable to vote at an Advance Poll or on Polling Day in theconstituency in which I am an ordinary resident due to a disability or I am providingcare to a person with a disability, and that enclosed in this envelope is a ballotenvelope that contains the ballot received by me and marked by me.

Dated this day of , 20 .

Signature of Voter

31 Oct 2014 SR 85/2014 s5.


90

E-6.01 REG 2

31 Oct 2014 SR 85/2014 s5.

FORM KKK[Section 89.3 of the Act]

Statement of Homebound Voters’ Ballots Delivered to the Returning Officer

Constituency of

BALLOTS COUNTED FOR EACH CANDIDATE







Number of rejected ballots

Axob tollab ni stollab ’sretov dnuobemoh latoT ´

´

NOTE:These Numbersmust be the same

NUMBER OF BALLOTS

Number of certificate envelopes deposited in ballot box

Number of unopened certificate envelopes rejected

Number of unopened outer envelopes received after the deadline

Number of ballot papers not returned (if any)

Number of ballot papers spoiled or declined

Number of unused ballot papers

Bstollab ’sretov dnuobemoh latoT ´

´

NOTE:TheseNumbersmust be the same

NUMBER OF BALLOTS

Total number of ballot papers assigned to the homebound voting process C

The seal locking this ballot box bears number . I certify that the above statement is correct. Dated at , Saskatchewan, this day of , 20 .


91ELECTION FORMS


FORM LLL[Sections 5, 66, and 89.3 of the Act]

Poll Book (Homebound Voters)

7654321

ConsecutiveNumber

Name of Voter Address of Voter (Street Number &

Name or Land Location)

Occupation PollingDivisionNumber

Number onVoters’

List

DateHomebound

VoterApplication

Received


92

E-6.01 REG 2

21110198

Date and time whenHomebound Voting

will take place

Address where Homebound Voting will occur (if difference from Column 3).

CertificateEnvelope

Rejected byReturning

Officer

CertificateEnvelope

Deposited inSealed Ballot

Box

Comments

31 Oct 2014 SR 85/2014 s5.

93ELECTION FORMS


FORM MMM[Subsection 29.1(2) of the Act]

Application for Revision

By completing this form you are agreeing to revise information on the Voters’ List or in the Register of Votersand you are confirming that you meet the requirements as an eligible voter.

CONSTITUENCY POLLING DIVISION

Provide name of voter as it appears on Voters’ List/Register of VotersETAD HTRIB)S(EMAN ELDDIMEMAN TSRIFEMAN TSAL

(YYYY/MM/DD)

/ /

Reason for Revision

PLEASE PRINT IN BLOCK LETTERS Complete only information that needs to be revised*Denotes mandatory information

VOTER INFORMATION

*)S(EMAN ELDDIM*EMAN TSRIF*EMAN TSAL

BIRTH DATE* (YYYY/MM/DD)

/ /

REBMUN ENOHP LLECREBMUN ENOHP EMOHREDNEG

*NEZITIC NAIDANAC A MA INOITAPUCCOSSERDDA LIAME

YES G

If not a Canadian Citizen:I AM A BRITISH SUBJECT WHO QUALIFIED AS A VOTER ON JUNE 23, 1971*

YES GORDINARY RESIDENCE – COMPLETE 1, 2 OR 3

1. HOME RESIDENCE (URBAN)*

APT/UNIT NUMBER BUILDING NUMBER STREET NAM EDOC LATSOPNWOT/YTICNOITCERID/E

2. HOME ADDRESS (RURAL) PROVIDE LEGAL LAND DESCRIPTION*

REMWEGRPWTCESRTQ

NALPKCOLBTOL

3. RESERVE NAME* HOUSE NUMBER

G I have ordinarily resided in Saskatchewan for at least sixmonths immediately preceding the day the writ wasissued*

G I was ordinarily resident in this constituency on the day the writ wasissued*

MAILING ADDRESS (IF MAIL IS NOT DELIVERED TO YOUR HOME ADDRESS)

EDOC LATSOPNWOT/YTIC


94

E-6.01 REG 2

For use by Election Officials

DATE OF REVISION REGISTRY IDENTIFICATION NUMBER VOTER PROVIDED ACCEPTABLEINDENTIFICATION*

G YES

IF DELETION BECAUSE OF DEATH, COPY OFDEATH CERTIFICATE PROVIDED

DATE OF DEATH (YYYY/MM/DD)

/ /

Signature Date

Signature of Returning Officer/Revising Officer Date

31 Oct 2014 SR 85/2014 s5.

95ELECTION FORMS


FORM NNN[Section 18.6 of the Act]

Application to Access Information in Register of Voters

I request access to information in the Register of Voters for Poll No. in the constituency of for:

Name of Voter: Please print Given Name, Initial and Last Name

Address:Physical land description or street, city, postal code

Birth Date: (YYYY/MM/DD)

G For myself.

G Acting on behalf of the voter named. If acting on behalf of a voter, the reason for acting on behalf ofvoter is

The purpose of this request is to:

G Determine whether the information on the Voters’ List in the Register of Voters is correct.

G Remove information from the Register of Voters

G Not include information in the Register of Voters

In accordance with the provisions of Section 18.6 of The Election Act, 1996, I acknowledge, undertake andagree as follows with respect to the information I obtain, directly or indirectly, from the Register of Voters forSaskatchewan including any voters’ list (hereinafter “voter information”), whether the voter information is inprinted or electronic format or examined in either format without obtaining a copy.The Election Act, 1996 – Section 216(1) Any person who contravenes any provision of this Act is guilty of an offence and is liable on summaryconviction to the penalties set out in this Act with respect to that offence.(2) If no penalty is prescribed with respect to that offence, the person, if convicted, is liable to a fine of notmore than $5,000 or to imprisonment for a term not exceeding two years or to both.

I have read, understand and agree to abide by the above provisions of The Election Act, 1996.

Name (Please Print) Address

Phone number:

Signature of Applicant Address

Signature of Returning Officer or Election Official Address

31 Oct 2014 SR 85/2014 s5.


96

E-6.01 REG 2

FORM OOO[Clauses 22(2)(b) and 22(5)(a) of the Act]

Enumeration/Registration at a PollPersonal information collected on this form will be used to register voters or to update voter information as

authorized under The Election Act, 1996. Any unauthorized use of this information is a violation of Section 216 of TheElection Act, 1996.

By providing information on this form, you are confirming that you meet the requirements as an eligible voter:

CONSTITUENCY POLLING DIVISION

PLEASE PRINT IN BLOCK LETTERS*Denotes mandatory information

VOTER INFORMATION

*)S(EMAN ELDDIM*EMAN TSRIF*EMAN TSAL

BIRTH DATE* (YYYY/MM/DD)

/ /

REBMUN ENOHP LLECREBMUN ENOHP EMOHREDNEG

*NEZITIC NAIDANAC A MA INOITAPUCCOSSERDDA LIAME

YES G

If not a Canadian Citizen:I AM A BRITISH SUBJECT WHO QUALIFIED AS A VOTER ON JUNE 23, 1971*

YES G

ORDINARY RESIDENCE – COMPLETE 1, 2 OR 3

1. HOME RESIDENCE (URBAN)*

APT/UNIT NUMBER HOUSE/BUILDING NUMBER STREET EDOC LATSOPNWOT/YTICNOITCERID/EMAN

2. HOME ADDRESS (RURAL) PROVIDE LEGAL LAND DESCRIPTION*

REMWEGRPWTCESRTQ

NALPKCOLBTOL

3. RESERVE NAME* HOUSE NUMBER

G I have ordinarily resided in Saskatchewan for at least sixmonths immediately preceding the day the writ wasissued*

G I was ordinarily resident in this constituency on the day the writ wasissued*

MAILING ADDRESS (IF MAIL IS NOT DELIVERED TO YOUR HOME ADDRESS)

EDOC LATSOPNWOT/YTIC

For use by Election Officials

REBMUN NOITACIFITNEDI YRTSIGERNOISIVER FO ETADNOITARTSIGER FO ETAD

Signature of Election Official

31 Oct 2014 SR 85/2014 s5.

REGINA, SASKATCHEWAN

Printed by the authority of THE QUEEN’S PRINTER

Copyright©2015

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