55

THE TAMIL NADU PANCHAYAT S (ELECTIONS) RULES, 1995

Election of

FORM 3
NOMINATION PAPER
[See rule 26 (1) and (2) and 30]
Member to Ward No............................... of the ...............................................
Village Panchayat/Panchayat Union Council/District Panchayat.
President to the ...........................................Village Panchayat

(To be filled in by the proposer)

I hereby nominate Thiru/Tmt/Selvi................................................as a candidate for the
election as a member from Ward No.........................of the ................................ Village
Panchayat/Panchayat Union Council/District Panchayat/ President of............................................
Village Panchayat.
His/Her name is entered at serial No. ........... in part No. ............... of the electoral roll for
ward
No.
............
of
...............................
Village
Panchayat
comprised
in
........................................... Panchayat Union.
My name is entered at serial No. ........... in part No. ............... of the electoral roll for ward
No. ............ of ............................... Village Panchayat comprised in ...........................................
Panchayat Union.
Date:..............................
Signature of the proposer.
(To be filled by the candidate)
I, the above mentioned candidate assent to this nomination and hereby declare (a) that I have completed ............................................................ years of age;
(b) ** that the symbols I have chosen are in the following order of preference:
(i)............................................................
(ii)............................................................
(iii)............................................................
(c) that I am aware of the fact that under Rule 30 of the Tamil Nadu Panchayats
(Elections) Rules, 1995, I am prohibited from contesting more than one seat as below and further
that a nomination filed in violation of sub-rule (1) of the above mentioned rule shall be rejected by
the Returning Officer:(i) No member of a Village Panchayat or no person who stands for election as a
member of a Village Panchayat shall be eligible to stand for election as a President
of a Village Panchayat, or a member of a Panchayat Union Council or a member of a
District Panchayat.
(ii) No member of a Panchayat Union Council or no person who stands for election as a
member of a Panchayat Union Council shall be eligible to stand for election as a
member of a Village Panchayat, or President of a Village Panchayat or a member of
a District Panchayat.
(iii) No member of a District Panchayat or no person who stands for election as a
member of a District Panchayat shall be eligible to stand for election as a member of
a Village Panchayat, or President of a Village Panchayat or a member of a
Panchayat Union Council.
(iv) No President or no person who stands for election as a President shall be eligible to
stand for election as a member of a Village Panchayat, or member of a Panchayat
Union Council or a member of a District Panchayat.

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THE TAMIL NADU PANCHAYAT S (ELECTIONS) RULES, 1995

(v) Under Section 10 of the Tamil Nadu Panchayats Act, 1994, no person shall be
eligible to be elected as a member of more than one Village Panchayat.
(d) that I am a member of the ........................................... caste/ tribe which is a Scheduled
Caste/Tribe *** of the State of Tamil Nadu in relation to................................................. (area).
Date:....................................
Signature of the Candidate.
Note:
item (b) need not be filled in by candidates for election of member of a Village Panchayat.
item (d) needs to be made only by a SC/ST/ BC candidate.
****item (e) that I am not employed as Village Administrative Officer or Village Servant or an
Officer or Servant of the State or Central Government or of a Village Panchayat, Panchayat Union
Council, District Panchayat, Municipal Council or Municipal Corporation or of any Industrial
Township or of Contonment or of any body Corporate, owned or controlled by the State or Central
Government.
***(The words and Backward Classes omitted as per amendment issued in G.O.Ms.No.163,
Rual Development Department, Dated 7.8.1996)
****(This item added in G.O.(Ms.)No.164, Rural Development (C4) Dept. dated 27.10.2004
(To be filled by the Returning Officer)
Serial number of nomination paper:
The nomination was delivered to me at my office at ........................... (hour) on ...........................
(date) by the candidate/proposer.
Date:
Returning Officer.

Receipt for nomination paper and notice of scrutiny.

(To be handed over to the person presenting the nomination paper)
Serial number of nomination paper:
The nomination paper of ........................................ a candidate for election as President/member
from ward No................... of the Village Panchayat/Panchayat Union/District Panchayat, was
delivered to me at my office at .......................... (hour) on .................................... (date) by the
candidate/proposer.
All nomination papers will be taken up for scrutiny at 11.00 a.m. on ...................... (date) at
............................. (place).
Date:............................
Returning Officer/Assistant Returning Officer.