FIRST SCHEDULE
FORM 1
Section 24(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
WRIT OF ELECTION
 
By
President of the Republic of Singapore
To: RETURNING OFFICER
  WHEREAS section 24(1) of the Parliamentary Elections Act provides that for the purposes of every general election of Members of Parliament, and for the purposes of the election of Members to supply vacancies caused by death, resignation or otherwise, the President shall issue writs under the public seal, addressed to the Returning Officer:
  *AND WHEREAS I think it is expedient that a writ should now be issued for the election of Members to serve in Parliament:
  †AND WHEREAS the seat of the Elected Member/**seats of the Elected Members for the Electoral Division of                         has/**have become vacant.
  NOW, therefore, I,                                           , the President, do hereby require that, after notice of the time and place or places fixed for the nomination of candidates has been given in accordance with the Parliamentary Elections Act, you do on          (date)           at the respective places specified in the Schedule to this Writ, cause election or elections to be made according to the Act for the election of the Member for the Electoral Division/**the Members for the Electoral Division/*the Members for the Electoral Divisions specified opposite that place in the Schedule to this Writ, and that, if necessary, you do cause a poll or polls to be taken on the date required to be notified under section 34(6)(d)/**section 34A(6)(d) of the Parliamentary Elections Act.
  The place/*places of nomination of candidates for the Electoral Division/*respective Electoral Divisions is/*are given in the Schedule to this Writ.
Given under my hand and the seal of the Republic of Singapore this       day of                               .
 
President.
*to be retained in a writ for a general election.
†to be retained in a writ for a by-election.
**to be retained in a writ for an election in a Group Representation Constituency.
THE SCHEDULE
Place of nomination
(Nomination centre)
Electoral Division
(Set out address or addresses of nomination centre or centres)
(Set out Electoral Division or Divisions)
 
 
 
 
 
 
 
 
FORM 2
[Deleted by S 231/2019 wef 01/04/2019]
FORM 3
Section 11(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
FORM OF CLAIM BY PERSON WHOSE NAME HAS BEEN
OMITTED OR EXPUNGED FROM THE REGISTER
To:THE REGISTRATION OFFICER
Elections Department
Electoral Division of

………………………
For Official Use
Registration No.
I
PARTICULARS OF CLAIMANT AS SHOWN IN IDENTITY CARD
Telephone (Home/Work)
 
NRIC No.
Sex
Date of Birth
Telephone (Mobile)
 
 
 
 
Date Citizenship Acquired
(if applicable)*
 
Name (in block letters and underline surname)
Date of Report on
Change of Address
(if applicable)**
 
Address
Postal Code
 
                    I, the abovenamed person, certify that to the best of my knowledge and belief the above information given by me is true and I am applying to have my name inserted/retained in the Register of Electors on the following grounds:


…………………
Date
 

……………………………………………….…………..
(Signature or thumb mark of Claimant)
* Applicable to a person who makes this application on the ground that he has recently acquired Singapore citizenship.
** Applicable to a person who makes this application on the ground that his address has changed.
II
ACTION BY INSPECTION CENTRE CLERK:
 
 
The ground of claim is (please tick below)
 
 
Name omitted from Register of Electors
 
 
Change of address
 
 
Change of name
 
 
Other ground
 
 
 

…………………
Date

……………………………
Name (in block letters)

………………………
Signature
 
 
 
 
 
III
ACTION BY ELECTIONS DEPARTMENT
 
 
ARO’S COMMENTS
TYPE OF DECISIONS
ARO’S DECISION
 
 
 
 
INITIAL
DATE
 
 
 
Change of Address
 
 
 
 
 
Change of Particulars
Name
 
 
 
 
 
 
Sex
 
 
 
 
 
Restored Voter
 
 
 
 
 
New Voter
 
 
 
 
 
No Action
 
 
 
 
 
Disallowed
 
 
 
 
REMARKS
 
[S 3/2019 wef 02/01/2019]
FORM 4
Section 11(5)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
FORM OF OBJECTION
To:THE REGISTRATION OFFICER
Elections Department
Electoral Division of
…………………………………………………..……
………………………………………………..………
PARTICULARS OF PERSON MAKING OBJECTION
Name (in block letters)
NRIC No.
 
 
 
 
 
 
 
 
 
Address (as shown in NRIC)
Polling District
 
 
 
 
 
 
 
Serial No.
 
 
 
 
 
 
               I, the abovenamed person, hereby declare that my name appears in the Register of Electors and that I wish to object to the name of the person mentioned and described below being included in the Register of Electors for the abovementioned Electoral Division. The grounds of my objection are specified below.
PARTICULARS AS APPEAR IN THE REGISTER OF ELECTORS OF PERSON OBJECTED TO
Grounds of Objection
Polling District
Name
Address
 
 
 
 
 
 
 
 
 
 
Serial No.
 
 
 
 
 
 
 
 
 
 
 
 
Dated this ............... day of .................................  .........
 
…….…………………………………………
Signature or thumb mark of Objector.
 
 
Signed or marked by the abovenamed objector in my presence,
………………..……..
Signature of Witness.
 
…………………………..
Name of Witness.
 
……………………..
Address of Witness.
 
 
 
 
 
FORM 5
Section 11(6)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
FORM OF OBJECTION AGAINST CLAIMANT
To:THE REGISTRATION OFFICER
Elections Department
Electoral Division of
…………………………………………………………
…………………………………………………………
PARTICULARS OF PERSON MAKING OBJECTION
Name (in block letters)
NRIC No.
 
 
 
 
 
 
 
 
 
Address (as shown in NRIC)
Polling District
 
 
 
 
 
 
 
Serial No.
 
 
 
 
 
 
I, the abovenamed person, hereby declare that my name appears in the Register of Electors and that I wish to object to the name of the claimant mentioned and described below being entered/retained in the Register of Electors for the abovementioned Electoral Division. The grounds of my objection are specified below.
PARTICULARS AS APPEAR IN THE CLAIMANTS LIST OF PERSON OBJECTED TO
Grounds of Objection
Name of Claimant Objected to
Address
 
 
 
 
 
 
 
 
 
 
Dated this .............. day of .................................. .........
 
…….…………………………………………
Signature or thumb mark of Objector.
Signed or marked by the abovenamed objector in my presence,
………………..……..
Signature of Witness.
 
…………………………..
Name of Witness.
 
……………………..
Address of Witness.
FORM 6
Section 11(8A)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
NOTICE TO PERSONS OBJECTED TO
TAKE NOTICE that I have received objections to the inclusion of your name and address in the proposed list of electors for Polling District No. …………….. of the Electoral Division of ………………….. and that a public inquiry will take place on the ............... day of ................................ ………. between the hours of ............... and ...............
AND FURTHER TAKE NOTICE that unless you appear before me and show cause why your name (should not be deleted from) (should be included in) the list of electors, your name (may be deleted therefrom) (may not be included therein).
The grounds of objections are ………………………………………………
 
 
 
 
 
…………………………………
Registration Officer.
 
 
Date ………………………
(Reverse side of Form)
(FORM 6)
(Frank)
TO BE SENT TO ALL PERSONS OBJECTED TO
……………………………………………………...
……………………………………………………...
(Name and address)
FORM 7
Sections 13(1) and 20A(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
CERTIFICATE OF REGISTRATION OFFICER
I, …………………………………………….., Registration Officer, certify that this is the Register of Electors for the Electoral Division of …………………… ……………………………………………………..
 
 
 
 
Dated this ................. day of ........................................... …………
 
 
 
……………………………..
Registration Officer.
 
 
FORM 8
Section 25
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
NOTICE OF ELECTION FOR
*THE ELECTORAL DIVISION OF __________________
*ALL ELECTORAL DIVISIONS
  TAKE NOTICE that the President having issued his Writ *for the election of *a Member/*Members of Parliament for the Electoral Division of ________________/ *for the general election of Members of Parliament for all Electoral Divisions, the Returning Officer will be holding the election as follows.
  Nomination papers of persons seeking election must be delivered to the Returning Officer on (specify date), between 11 a.m. and 12 noon (both times inclusive) at the place of nomination specified in the Schedule to the Writ against the Electoral Division concerned.
  Every nomination paper must be signed by at least 6 electors qualified to vote in the Electoral Division in which the nominee or group of nominees, as the case may be, is seeking election.
  A nomination paper will not be valid or acted upon by the Returning Officer unless it is accompanied by the following:
(a)the written consent of the nominee or nominees, as the case may be;
(b)for each nominee, an election deposit of $_________;
[S 231/2019 wef 01/04/2019]
(c)a statutory declaration by each nominee to the effect that he is qualified to be elected;
(d)a political donation certificate issued to the nominee from the Registrar of Political Donations under section 18(4) of the Political Donations Act (Cap. 236); and
(e)if the Electoral Division is a Group Representation Constituency, the certificate required to be delivered by a nominee in the group under section 27B(3)(c) of the Parliamentary Elections Act.
  Forms of nomination papers may be obtained after the date of this Notice from the office of the Returning Officer between _________ and _________ daily (except Sunday and public holidays), and between _________ and _________ on Saturdays. The office of the Returning Officer is situated at __________________.
  If the election in an Electoral Division is not contested, the Returning Officer will immediately declare the sole nominated candidate or group of candidates for the Electoral Division to be elected as the Member or Members of Parliament, as the case may be, for that Electoral Division.
  If, however, the election in an Electoral Division is contested, a poll will be held.
  Dated this          day of                                        .
 
 
 
Returning Officer,
Singapore
.
 
 
*Delete whichever is inapplicable.
FORM 9
Section 27(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
NOMINATION PAPER
SECTION A: TO BE COMPLETED BY PERSONS NOMINATING
DETAILS OF NOMINEE
NAME (in block letters)
NRIC NO.
SEX (Please circle)
OCCUPATION
 
 
 
 
 
 
 
 
 
 
M
F
 
DETAILS OF PERSONS NOMINATING
We, the persons specified below, being registered in the register of electors for the Electoral Division of ……………….., hereby nominate the above person as candidate for election as a Member of Parliament for the said Electoral Division:
NAME
NRIC NO.
SIGNATURE
PROPOSER
 
 
 
 
 
 
 
 
 
 
 
SECONDER
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 1
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 2
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 3
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 4
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 5
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 6
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 7
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 8
 
 
 
 
 
 
 
 
 
 
 
SECTION B: DECLARATION TO BE COMPLETED BY NOMINEE
I, the person nominated in Section A, do solemnly and sincerely declare that —
(a)I am duly qualified to be elected as a Member of Parliament for the Electoral Division of ………………;
(b)I consent to this nomination as candidate for election as a Member of Parliament for the said Electoral Division; and
*(c)I am a member of and am standing for (state name of political party) ………………………………………
*(c)I am an independent candidate.
*Delete whichever is inapplicable
And I make this solemn declaration by virtue of the Oaths and Declarations Act (Cap. 211), and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.
 
.................................................................................
Signature of Nominee
Dated this ............ day of ............................................................ 20......
Before Me
……………………………………………………...
 
…………………………………………………………
Name of Commissioner for Oaths/Justice of the Peace (in block letters)
 
Signature of Commissioner for Oaths/Justice of the Peace
I, the nominee, can be contacted at
Address:
 
Telephone Number:
FORM 9A
Section 27B(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
NOMINATION PAPER
SECTION A: TO BE COMPLETED BY PERSONS NOMINATING
DETAILS OF NOMINEES
NAME (in block letters)
NRIC NO.
SEX (Please circle)
OCCUPATION
1
 
 
 
 
 
 
 
 
 
M
F
 
2
 
 
 
 
 
 
 
 
 
M
F
 
3
 
 
 
 
 
 
 
 
 
M
F
 
4
 
 
 
 
 
 
 
 
 
M
F
 
5
 
 
 
 
 
 
 
 
 
M
F
 
6
 
 
 
 
 
 
 
 
 
M
F
 
DETAILS OF PERSONS NOMINATING
We, the persons specified below, being registered in the register of electors for the Electoral Division of ……………….., hereby nominate the above group of persons as candidates for election as Members of Parliament for the said Electoral Division:
NAME
NRIC NO.
SIGNATURE
PROPOSER
 
 
 
 
 
 
 
 
 
 
 
SECONDER
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 1
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 2
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 3
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 4
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 5
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 6
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 7
 
 
 
 
 
 
 
 
 
 
 
ASSENTOR 8
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
SECTION B: DECLARATION TO BE COMPLETED BY NOMINEES
 
 
We, the persons nominated in Section A, do each solemnly and sincerely declare that —
(a)We are each duly qualified to be elected as a Member of Parliament for the Electoral Division of ………....;
(b)We each consent to this nomination as candidate for election as a Member of Parliament for the said Electoral Division; and
*(c)We are each a member of and are standing for (state name of political party) ……………………………….
*(c)We are standing as a group of independent candidates.
*Delete whichever is inapplicable
And We each make this solemn declaration by virtue of the Oaths and Declarations Act (Cap. 211), and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.
 
 
.................................................................................
Signature of Nominee 1
 
 
 
 
 
.................................................................................
Signature of Nominee 2
 
 
 
 
 
.................................................................................
Signature of Nominee 3
 
 
 
 
 
.................................................................................
Signature of Nominee 4
 
 
 
 
 
.................................................................................
Signature of Nominee 5
 
 
 
 
 
.................................................................................
Signature of Nominee 6
 
 
Dated this ............ day of ............................................................ 20......
 
 
Before Me
 
 
…………………………………………………………
 
……………………………………………………….…
 
 
Name of Commissioner for Oaths/Justice of the Peace (in block letters)
 
Signature of Commissioner for Oaths/Justice of the Peace
 
 
We, the nominees, can be contacted at
Address:
 
 
 
Telephone Number:
 
 
 
 
 
FORM 10
[Deleted by Act 18 of 2005 wef 06/06/2005]
FORM 11
Sections 34(6) and 34A(6)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
NOTICE OF CONTESTED ELECTION
FOR THE ELECTORAL DIVISION OF __________________
  NOTICE is hereby given to the electors of the above Electoral Division that a Poll will be held for the Electoral Division as follows:
POLL IN SINGAPORE
  The Poll in Singapore will be held on (specify date). The Poll will open at 8 a.m. and close at 8 p.m. at the Polling Stations in the Electoral Division below:
Polling Stations
Polling Districts
 
 
 
 
 
 
 
 
OVERSEAS POLL
  The Poll at the following overseas polling stations will be held on the date and at the times specified below opposite the overseas polling station:
Overseas Polling Station
Date
Time
 
 
 
 
 
 
 
 
 
  The candidates for election in the above Electoral Division and their symbols, and their respective proposers and seconders are as follows:
Candidate
Symbol
Proposer
Seconder
 
 
 
 
 
 
 
 
 
 
 
 
Dated this          day of                                     .
 
Returning Officer,
Singapore
.
FORM 12
Section 40(3A)
FACE OF BALLOT PAPER
[S 231/2019 wef 01/04/2019]
FORM 12
Section 40(3A)
FACE OF BALLOT PAPER
FOR GROUP REPRESENTATION CONSTITUENCY
[S 231/2019 wef 01/04/2019]
FORM 13
[Deleted by S 231/2019 wef 01/04/2019]
FORM 14
[Deleted by S 231/2019 wef 01/04/2019]
FORM 15
Section 44(1)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)

DECLARATION BY VOTER

PARTICULARS OF VOTER
Name (in block letters)
NRIC No.
 
 
Address (as shown in NRIC)
Polling District and Serial Number of Voter shown in the Register of Electors
 
Polling District
Voter Serial No.
 
 
 
I, the abovenamed person, declare that I am the same person whose name appears as ………………………………………………………… in the Register of Electors in force for the Electoral Division of ………….…………………………………………… and that I have not already voted either here or elsewhere at this election.
 
 
………………….……..….……..…
Signature or thumb mark of Voter
 
 
 
Declared before me on .............................….
 
 
……………………….…………..…
Name of Presiding Officer
…………………..….…….………………
Signature of Presiding Officer
 
 
[S 231/2019 wef 01/04/2019]
FORM 16
Section 46(1)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)

OATH OF IDENTITY

PARTICULARS OF VOTER
Name (in block letters)
NRIC No.
 
 
Address (as shown in NRIC)
Polling District and Serial Number of Voter shown in the Register of Electors
 
Polling District
Voter Serial No.
 
 
 
I, the abovenamed person, *swear/affirm that I am the same person whose name appears as ………………………………………………………… in the Register of Electors in force for the Electoral Division of ………….…………………………………………… and that I have not already voted either here or elsewhere at this election.
 
 
………………..……………….…..….……..…
Signature or thumb mark of Voter
 
 
 
*Sworn/Affirmed before me on .............................….
 
 
…………………………….……………....…
Name of Presiding Officer
……………………………………………
Signature of Presiding Officer
 
 
*Delete whichever is inapplicable.
[S 231/2019 wef 01/04/2019]
FORM 16A
Section 49(7A)(b)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)

RECORD OF COUNTING

Electoral Division
:
 
GARO Centre
:
 
Counting Centre
:
 
Counting Place No.
:
 
For counting of votes cast at the following Polling Station(s):
Number of Ballot Papers Issued for the Poll at the above Polling Station(s)
 
Number of Ballot Papers cast for
Name(s) of Candidate/
Candidates in Group
Symbol
Count
Recount
(if applicable)
 
 
 
 
 
 
 
 
Total Number of Ballot Papers cast for the above Candidates
 
 
Number of Rejected Ballot Papers
 
 
Total Number of Ballot Papers found in the ballot boxes from the above Polling Station(s)
 
 
Total Number of Electors in the Register of Electors used at the Poll at the above Polling Station(s)
 
Date and time of announcement of results to candidate(s)/counting agent(s) in attendance:
Count
Recount (if applicable)
Date: ………………. Time: ………..
Date: ………………. Time: ………..
I certify that the above record of counting of votes is correct.
I certify that the above record of recounting of votes is correct.
..……………………….......………………………..
Name of Assistant Returning Officer
..…………………………..............…………….…
Name of Assistant Returning Officer
..……………………........………….…….……..…
Signature of Assistant Returning Officer
..……………………….................……………..…
Signature of Assistant Returning Officer
Date: ……………….
Date: ……………….
[S 231/2019 wef 01/04/2019]
FORM 17
Section 51
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
STATEMENT OF THE POLL AFTER COUNTING THE BALLOTS
ELECTORAL DIVISION OF
‡Number of Ballot Papers Issued
Number of Ballot Papers cast for
 
Name of Candidate
Party
‡Number of Ballot Papers
 
 
 
 
 
‡Total Number of Ballot Papers cast for the above Candidates
 
Number of *Rejected Ballot Papers
 
Total Number of Ballot Papers found in the ballot boxes
 
Number of Unused Ballot Papers undetached from the books
 
Number of †Spoilt Ballot Papers
 
 
‡TOTAL
 
  *A Rejected Ballot Paper means a ballot paper which has been handed by the presiding officer to an elector to cast his vote but which, at the close of the poll, has been found in the ballot box unmarked or so improperly marked it cannot be counted.
  †A Spoilt Ballot Paper means a ballot paper which, on polling day, has not been deposited in the ballot box, but has been found by the presiding officer to be spoilt or improperly printed or which has been handed by the presiding officer to an elector to cast his vote, and (a) has been spoilt in marking by the elector, and (b) has been handed back to the presiding officer and exchanged for another.
  ‡The numbers in this statement account for the votes cast in all local and overseas polling stations for the electoral division.
Total Number of Electors in the Register of Electors used at the Poll
 
I hereby certify that the above statement is correct.
Dated this           day of                                  .
 
 
 
Returning Officer,
Singapore
.
FORM 18
Section 56(1)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
FORM OF OATH OF SECRECY
RETURNING OFFICER
Elections Department
Electoral Division of
……………………………………
……………………………………
PARTICULARS OF PERSON TAKING THE OATH
Name (in block letters)
NRIC No.
 
 
 
 
 
 
 
 
 
Address (as shown in NRIC)
  I, the abovenamed person, swear that I will not at this election in the abovementioned Electoral Division do anything forbidden by section 56 of the Parliamentary Elections Act which has been read to me.
 
 
……………………………………..…
Signature of Person taking the Oath.
 
 
 
Sworn before me, this ................ day of ............................... ……….
 
 
…………………………………………….
Signature of Justice of the Peace/ Commissioner for Oaths.
……………………………………………
Name (in block letters).
 
 
Note:Section 56 of the Parliamentary Elections Act (printed overleaf) must be read to the person taking the Oath. No stamp fee is required.
56.(1)  Every officer, clerk, interpreter, candidate and agent authorised to attend at a polling station, or at the counting of the votes, shall, before so attending, make an oath of secrecy, substantially in Form 18 in the First Schedule.
(2)  The Returning Officer shall have power to administer any oaths required to be taken under subsection (1).
(3)  Subject to subsection (3A), every officer, clerk, interpreter, candidate and agent in attendance at a polling station shall maintain, and aid in maintaining, the secrecy of the voting in the station, and shall not communicate, except for some purpose authorised by law, before the poll is closed, to any person any information as to the name or number on the register of electors of any elector who has or has not applied for a ballot paper or voted at that station, or as to the official mark.
(3A)  The total number of voters who have voted at any station at any time before the poll is closed may, in the discretion of the presiding officer, be divulged to the candidate or his agent authorised to attend at the polling station.
(4)  No such officer, clerk, interpreter, candidate or agent, and no person shall —
(a)attempt to obtain in the polling station information as to the candidate or group of candidates, for whom any voter in the station is about to vote or has voted; or
(b)communicate at any time to any person any information obtained in a polling station as to the candidate or group of candidates, for whom any voter in the station is about to vote or has voted, or as to the number on the back of the ballot paper given to any voter at the station.
(5)  Every officer, clerk, interpreter, candidate and agent in attendance at the counting of the votes shall maintain, and aid in maintaining, the secrecy of the voting, and shall not —
(a)attempt to ascertain at the counting the number on the back of any ballot paper; or
(b)communicate any information obtained at the counting as to the candidate or group of candidates, for whom any vote is given by any particular ballot paper.
(6)  No person, except a presiding officer acting for a purpose authorised by this Act or a person authorised by the presiding officer and acting for that purpose, shall communicate or attempt to communicate with any voter after the voter has received a ballot paper and before he has placed it in a ballot box, or after the voter has been authorised to use an approved DRE voting machine to mark or record his vote and before he marks or records his vote at the machine, as the case may be.
(7)  Every person who acts in contravention of this section shall be guilty of an offence and shall be liable on conviction to a fine not exceeding $1,500 or to imprisonment for a term not exceeding 9 months or to both.
FORM 19
Section 74(1) and (2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
RETURN RESPECTING ELECTION EXPENSES AND
DECLARATIONS BY CANDIDATE AND ELECTION AGENT
ELECTORAL DIVISION
 
 
NAME (in block letters)
NRIC NO.
CANDIDATE
 
ELECTION AGENT
 
   *I, the above duly appointed election agent of the above candidate for election in the above Electoral Division, make this return respecting election expenses of the candidate at that election.
   *I, the above candidate for election in the above Electoral Division and acting as my own election agent, make this return respecting my election expenses at that election.
   This return respecting election expenses shows —
(a)all payments made by the election agent;
(b)the amount of personal expenses, if any, paid by the candidate;
(c)the disputed claims so far as the election agent is aware of;
(d)all unpaid claims, if any, of which the election agent is aware in respect of which application has been made or is about to be made to an Election Judge or a Judge of the High Court; and
(e)all donations accepted by the election agent or the candidate for the purpose of expenses incurred or to be incurred on account of or in respect of the management of that election.
   I declare to the best of my knowledge and belief that this is a complete and correct return as required by law and that, except for the expenses set out in this return, no other expenses of any nature have been incurred in, or for the purpose of, the candidate’s candidature at that election.
 
 
 
___________________________
Signature of Election Agent
 
_________________
Date
 
    I, the above candidate for election in the above Electoral Division, have examined this return respecting election expenses prepared by my election agent in respect of my candidature at that election. I declare to the best of my knowledge and belief that this return is complete and correct as required by law and that, except for the expenses set out in this return, no other expenses of any nature have been incurred in, or for the purpose of, my candidature at that election.
 
___________________________
Signature of Candidate
 
_________________
Date
 
*Delete whichever is inapplicable.
SECTION A: EXPENSES
(Fill in the total amount of expenses for each category, in Singapore dollars, rounded up to the nearest dollar. Write NIL if there is no expense to declare.)
 
 
 
 
Description
$
 
 
(a)Election advertising expenses:
 
 
(i)For print election advertising
 
 
 
(ii)For Internet election advertising
 
 
 
(iii)For other non-print election advertising
 
 
 
(b)Election meeting expenses:
 
 
(i)For rallies
 
 
 
(ii)For assembly centres
 
 
 
(c)Transport expenses
 
 
 
(d)Office rental and office supplies expenses
 
 
 
(e)Allowances for election agent, polling agent(s) and counting agent(s)
 
 
 
(f)Other expenses
 
 
 
(g)Personal expenses of candidate
 
 
 
TOTAL
 
 
 
 
 
 
SECTION B: DISPUTED AND UNPAID CLAIMS
(Fill in the total amount of claims for each category, in Singapore dollars, rounded up to the nearest dollar. Write NIL if there is no claim to declare. If there is insufficient space in any section, attach a separate sheet containing the details.)
 
 
 
 
(1)DISPUTED CLAIMS
 
 
Name and description
of claimant
Subject matter of claim
$
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TOTAL
 
 
 
 
 
 
 
(2)UNPAID CLAIMS (in respect of which application has been made or is about to be made to an Election Judge or a Judge of the High Court)
 
 
Name and description
of claimant
Subject matter of claim
$
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TOTAL
 
 
 
 
 
 
SECTION C: NON-RECORDABLE DONATIONS1
(Provide details of non-recordable donations accepted and particulars of their donors, in chronological order according to the date each donation is received. Write NIL if there is no donation to declare. Include only donations given, spent, lent or provided (whether before or after the candidate became a candidate) for the purposes of the candidate’s election. If there is insufficient space in any section, attach a separate sheet containing the details and particulars.)
 
 
 
 
Donor’s name2
and unique
identification
number
3
Donor’s
address
4
Date of receipt
of donation
5
and recipient’s
name
(
e.g. 28/08/00 by (name))
Value of
donation
5
(in Singapore
dollars, rounded up
to the nearest
dollar
)
Description of
donation
5
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TOTAL
 
 
 
 
 
 
 
 
 
 
 
 
 
 
1Donations that need not be recorded in a donation report under the Political Donations Act (Cap. 236).
 
 
2Donor’s name means (a) where the donor is an individual, the donor’s name as specified in the donor’s NRIC; or (b) where the donor is a company, the donor’s registered name under the Companies Act (Cap. 50).
 
 
3Donor’s unique identification number means (a) where the donor is an individual, the donor’s NRIC number; or (b) where the donor is a company, the company’s registration number under the Companies Act.
 
 
4Donor’s address means (a) where the donor is an individual, the donor’s address as specified in the donor’s NRIC; or (b) where the donor is a company, the address of the donor’s registered office in Singapore.
 
 
5The expressions “donation” and “value of donation” have the meanings given by sections 3, 4 and 5 of the Political Donations Act. For a donation-in-kind, the value of the donation is the value of the item at the date of receipt of the item.
 
SECTION D: RECORDABLE DONATIONS
(Provide details of single and multiple recordable donations accepted and particulars of their donors, in chronological order according to the date each donation is received. Write NIL if there is no donation to declare. Include only donations given, spent, lent or provided (whether before or after the candidate became a candidate) for the purposes of the candidate’s election. If there is insufficient space in any section, attach a separate sheet containing the details and particulars.)
 
 
 
 
(1)SINGLE RECORDABLE DONATIONS
(Recordable donation means a donation required to be recorded in a donation report under the Political Donations Act. A single recordable donation means a single donation of $10,000 or more.)
 
 
Donor’s
name
1
and unique
identification
number
2
Donor’s
address
3
Date of
receipt
of donation
4
and recipient’s
name
(
e.g. 28/08/00 by (name))
Value of
donation
4
(in Singapore
dollars, rounded up
to the nearest
dollar
)
Description of
donation
4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TOTAL
 
 
 
 
 
 
 
 
 
 
 
1Donor’s name means (a) where the donor is an individual, the donor’s name as specified in the donor’s NRIC; or (b) where the donor is a company, the donor’s registered name under the Companies Act.
 
 
2Donor’s unique identification number means (a) where the donor is an individual, the donor’s NRIC number; or (b) where the donor is a company, the company’s registration number under the Companies Act.
 
 
3Donor’s address means (a) where the donor is an individual, the donor’s address as specified in the donor’s NRIC; or (b) where the donor is a company, the address of the donor’s registered office in Singapore.
 
 
4The expressions “donation” and “value of donation” have the meanings given by sections 3, 4 and 5 of the Political Donations Act. For a donation-in-kind, the value of the donation is the value of the item at the date of receipt of the item.
 
 
 
 
 
(2)MULTIPLE RECORDABLE DONATIONS
(Recordable donation means a donation required to be recorded in a donation report under the Political Donations Act. A multiple recordable donation means a donation which, when added to any other donation made by the same donor during the same reporting period under the Political Donations Act, amounts to an aggregate of $10,000 or more.)
 
 
Donor’s
name
1
and unique
identification
number
2
Donor’s
address
3
Date of
receipt
of donation
4
and recipient’s
name
(
e.g. 28/08/00 by (name))
Value of
donation
4
(in Singapore
dollars, rounded up
to the nearest
dollar
)
Description of
donation
4
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sub-total
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sub-total
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sub-total
 
 
 
 
 
 
TOTAL
 
 
 
 
 
 
 
 
 
 
 
1Donor’s name means (a) where the donor is an individual, the donor’s name as specified in the donor’s NRIC; or (b) where the donor is a company, the donor’s registered name under the Companies Act.
 
 
2Donor’s unique identification number means (a) where the donor is an individual, the donor’s NRIC number; or (b) where the donor is a company, the company’s registration number under the Companies Act.
 
 
3Donor’s address means (a) where the donor is an individual, the donor’s address as specified in the donor’s NRIC; or (b) where the donor is a company, the address of the donor’s registered office in Singapore.
 
 
4The expressions “donation” and “value of donation” have the meanings given by sections 3, 4 and 5 of the Political Donations Act. For a donation-in-kind, the value of the donation is the value of the item at the date of receipt of the item.
 
[S 443/2020 wef 08/06/2020]
FORM 19A
[Deleted by S 443/2020 wef 08/06/2020]
FORM 20
[Deleted by S 443/2020 wef 08/06/2020]
FORM 20A
[Deleted by S 443/2020 wef 08/06/2020]
FORM 21
[Deleted by Act 18 of 2005 wef 06/06/2005]
FORM 22
Section 83(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
AUTHORITY TO CONDUCT ELECTION ACTIVITY
To:RETURNING OFFICER
Elections Department
From:
………………………………………
(Name of Candidate)
….………….……………………………
(Contesting Electoral Division)
……….…………………………
…………………….…….………………
(Address)
…………………..………………………
(Political Party)
  I, the abovenamed candidate for election in the Electoral Division of …………………………, do hereby authorise the undermentioned person to conduct election activities on my behalf.
2.  To the best of my knowledge and belief the undermentioned person is not prohibited under section 83 of the Parliamentary Elections Act to conduct any election activity.
3.  This authorisation extends to publishing online, during the campaign period of the election, any election advertising, but only in accordance with the following conditions:
(a)before the election advertising is so published, the particulars of every platform on which the election advertising is to be published by the undermentioned person during the campaign period must be given in writing to myself or my election agent;
(b)the period that the election advertising will start appearing or appear online must be specified in writing to myself or my election agent by the undermentioned person, and updated by that person if the period is changed;
(c)that the undermentioned person must declare, under his hand, to myself or my election agent —
(i)whether any money or money’s worth (including sponsorship) is received or paid or to be received or paid (directly or indirectly) for publishing the election advertising, from or by another person except myself or my election agent; and
(ii)the name and other sufficient particulars to identify that other person in sub-paragraph (i) if money or money’s worth is received or paid or to be received or paid, and the amount paid or to be paid by the undermentioned person for publishing the election advertising.
Name (in block letters)
NRIC No.
 
 
 
 
 
 
 
 
 
Address (as shown in NRIC)
 
 
 
………………………..
                Date.
 
……………………………….
Signature of Candidate.        
 
 
 
[S 443/2020 wef 08/06/2020]
FORM 23
Section 83(2)
PARLIAMENTARY ELECTIONS ACT
(CHAPTER 218)
______________
AUTHORITY TO CONDUCT ELECTION ACTIVITY
To:RETURNING OFFICER
Elections Department
From:
………….……………………………
(Name of Election Agent)
…………………..………………………
(Contesting Electoral Division)
………….………………………
.………………….………………………
(Address)
……………..……………………………
(Political Party)
I, being the election agent of …………………………………………………,
(Name of Candidate)
a candidate for election in the abovementioned Electoral Division, hereby authorise the undermentioned person to conduct election activities on behalf of the said candidate.
2.  To the best of my knowledge and belief the undermentioned person is not prohibited under section 83 of the Parliamentary Elections Act to conduct any election activity.
3.  This authorisation extends to publishing online, during the campaign period of the election, any election advertising, but only in accordance with the following conditions:
(a)before the election advertising is so published, the particulars of every platform on which the election advertising is to be published by the undermentioned person during the campaign period must be given in writing to myself or the candidate;
(b)the period that the election advertising will start appearing or appear online must be specified in writing to myself or the candidate by the undermentioned person, and updated by that person if the period is changed;
(c)that the undermentioned person must declare, under his hand, to myself or the candidate —
(i)whether any money or money’s worth (including sponsorship) is received or paid or to be received or paid (directly or indirectly) for publishing the election advertising, from or by another person except myself or the candidate; and
(ii)the name and other sufficient particulars to identify that other person in sub-paragraph (i) if money or money’s worth is received or paid or to be received or paid, and the amount paid or to be paid by the undermentioned person for publishing the election advertising.
Name (in block letters)
NRIC No.
 
 
 
 
 
 
 
 
 
Address (as shown in NRIC)
 
 
………………………..
                Date.
 
……………………………….
Signature of Election Agent.     
 
 
 
 
 
 
[18/2005; S 528/96; S 522/2001; S 389/2005; S 232/2006; S 141/2011]
[S 443/2020 wef 08/06/2020]