Presiding Officer'S Diary

PRESIDING OFFICER’S DIARY
1. Name of the constituency (in block letters):

2. Date of poll :
3. Number of the polling station :
Whether located in-
(i) Government or quasi-government building;
(ii) Private building;
(iii) Temporary structure;
4. Number of polling officers recruited locally, if any :

5. Appointment of polling officer made in the absence of duly
appointed polling officer, if any, and the reasons for such appointment :
6. Voting Machine-
(i) Number of Control Units used :
(ii) S. No. (s) of Control Units used :
(iii) Number of balloting units used :
(iv) S. No. of balloting units used :
7. (i) Number of paper seals used :

(ii) Sl. Nos. of paper seals used :
7A. (i) Number of special tags supplied:

(ii) S.No.(s) of special tags supplied:
(iii) Number of special tags used:
(iv) S.No.(s) of special tags used:
(v) S.No.(s) of special tags returned as unused:
7B. (i) Number of Strip Seals supplied:

(ii) S.No.(s) of Strip Seals supplied:
(iii) Number of Strip Seals used:
(iv) S.No.(s) of Strip Seals used:
(v) S.No.(s) of Strip Seals returned as unused:
8. Number of polling agents and the number who arrived late :

9. Number of candidates who had appointed polling agents at the polling stations :
10. (i) Total no. of voters assigned to the polling station:
(ii) Number of electors allowed to vote according to marked copy of the electoral roll:
(iii) Number of electors who actually voted as per the Register of Voters (From-12).
(iv) Number of votes recorded as per the voting machine:
Signature of first Polling Officer Signature of Polling Officer

in-charge of Register of Voters
11. Number of electors who voted-
Men...........................................................
Women .....................................................
Total ...........................................................
12. Challenged vote-
Number allowed .......................................
Number rejected ......................................
Amount forfeited Rs. .................................
13. Number of persons who have voted on production of Election Duty
Certificate (EDC) :
14. Number of electors who voted with the help of companions :
15. Number of tendered votes :
16. No. of electors-
From whom declarations as to their age obtained ...................................
Who refused to give such declaration .......................................................
17. Whether it was necessary to adjourn the poll and if so, the reasons for such
adjournment :
18. Number of votes castfrom
8 a.m. to 10 a.m.
from 10 a.m. to 12 Noon.
from 12 Noon to 2 p.m.
from 2 p.m. to 4 p.m.
19. Number of voter's slips issued at the closing hour of the poll :
20. Electoral offences with details :
Number of cases of-
(a) canvassing within one hundred metres of the polling station :
(b) impersonation of voters :
(c) fraudulent defacing, destroying or removal of the list of notice or other document at
the polling station.
(d) bribing of voters :
(e) intimidation of voters and other persons :
(f) booth capturing
21. Was the poll interrupted or obstructed by-
(1) riot :
(2) open violence :
(3) natural calamity :
(4) booth capturing:
(5) failure of voting machine:
(6) any other cause :
Please give details of the above.
22. Was the poll vitiated by any voting machine used at the polling station having been-
(a) unlawfully taken out of the custody of the Presiding Officer:.
(b) accidentally or intentionally lost or destroyed :
(c) damaged or tampered with :
Please give details
23. Serious complaints, if any, made by the candidate/agents :
24. Number of cases of breach of law and order :
25. Report of mistakes and irregularities committed, if any, at the polling station :
26. Whether the declarations have been made before the commencement of the poll and if
necessary during the course of poll when a new voting machine is used and at the end
of poll as necessary :
Place ....................................
Date ..................................... Presiding Officer
This diary should be forwarded to the Returning Officer along with the voting machine and other
sealed papers.

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PRESIDING OFFICER’S DIARY

1. Name of the constituency (in block letters):

4. Number of polling officers recruited locally, if any :

7. (i) Number of paper seals used :

7A. (i) Number of special tags supplied:

7B. (i) Number of Strip Seals supplied:

8. Number of polling agents and the number who arrived late :

Signature of first Polling Officer Signature of Polling Officer

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