X

LAST NAME

GLE 040 'snqшnjo

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[әмурејд әниәт Г

FOR BOARD USE ONLY

WARD

TWP. PCT. SCH. VILL. DIST

ADDRESS

DATE CLERK

FIRST NAME

MIDDLE NAME

RECORD OF CHALLENGES

RECORD OF CANCELLATION

WARD

TWP PCT. SCH. VILL.

ADDRESS

DATE CLERK

DIST

GENERAL YEAR PRIMARY

99 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21

22 23 24 25 26 27 28 29 30 31

SPECIAL

SPECIAL

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