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| | Forms referred to in Parts 1 and 2 |
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| Note - The forms contained in this Part may be adapted so far as circumstances require. |
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| Form 1 - Form of corresponding number list (to be used for combined polls) |
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| Voting area/constituency/electoral region: ........................................ |
| | | | Date of Poll: ......................................... |
| | | | Sheet No.: ............................................. |
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| | | | | | | | | completed only in respect of |
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