HomeMy WebLinkAboutForm 12 - Campaign Worker Proof of ID Fillable.21FORM 12 Campaign Worker Proof of Identification
Local Authorities Election Act
(Section 52)
LOCAL JURISDICTION: ________________ , PROVINCE OF ALBERTA
ELECTION DATE:
VOTING SUBDIVISION OR WARD (If Applicable): ------------------
For the purposes of access authorized under section 52 of the Local Authorities Election Act, this
constitutes identification for ---------------------------
Name
of
Complete Address and Postal Code
serving in the capacity of
Office
This appointment is in effect for the 20 campaign period.
Section 52 of the Local Authorities Election Act states that a person to whom an enumerator, a
candidate, an official agent or a campaign worker on behalf of a candidate has produced identification in
the prescribed form, indicating that the person is an enumerator, a candidate, an official agent or a
campaign worker shall not
(a)obstruct or interfere with, or
(b)cause or permit the obstruction or interference with
the free access of the enumerator, candidate, official agent or campaign worker to each residence in a
building containing 2 or more residences or to each residence in a mobile home park.
Candidate's Signature Campaign Worker's Signature
LGS1364 Rev. 2019-02
County of Newell
October 18, 2021
21