Regulations > Regulations Concerning the Submission of Lists of Candidates, 2004 > Appendixes > Appendix 3/Annexure C : Nomination of Candidates for the Provincial Legislature (Provincial List) in terms of the Electoral Act, 1998

Annexure C

Appendix 3

Electoral Commission

Nomination of Candidates for the Provincial Legislature (Provincial List)

in terms of the Electoral Act, 1998

Election Date: ..............................................................................................................................

Province: ..............................................................................................................................

Name of Registered Party: ...........................................................................................................

I, ......................................................................................

(Name of Authorised Party Representative)

ID Number

Hereby:

1.	Undertake to bind the party, its candidates/persons holding political or executive office in the party, its representatives, members and supporters to the Electoral Code of Conduct;

2.	Declare I have confirmed that each candidate on the list is qualified to stand for election in terms of section 47 and/or section 106 of the Constitution of South Africa or national or provincial legislation or any applicable legislation;

3.	Declare that each candidate on the list is registered to vote within the province in which the election will take place.

4.	Attach proof that I have been duly authorized to make the nomination and undertaking on behalf of the party and to deal with matters in connection therewith; and

5.	Submit herewith proof of payment made in favour of the Electoral Commission as prescribed deposit for contesting the election.

6.	Give notice of intention to contest the Election for National Assembly (Regional List).


Place		Signature		Date

Contact # (1)

Contact # (2)

Email Address:

Address:

Important: No person may make a false statement or furnish false particulars in any document prescribed by these regulations. It is a criminal offence to do so.

[Appendix 3/Annexure C substituted by section 10(10.2) of the Amendment to the Regulations Concerning the Submission of Candidates, 2024, Notice No. 4304, GG50066, dated 1 February 2024]

List of Candidates for the Provincial Legislature (Provincial List) in terms of the Electoral Act, 1998 (Act No. 73 of 1998)

Name of Party

Region

Order #	Identity Number	Full Name(s)	Surname
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

NB: A4 paper on which the necessary columns have been drawn may be issued if the space provided is inadequate.

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[Appendix 3/Annexure C substituted by section 10(10.2) of the Amendment to the Regulations Concerning the Submission of Candidates, 2024, Notice No. 4304, GG50066, dated 1 February 2024]