Annexure XI(ii)-F

PRESIDING OFFICERS DAIRY

1. Name of the Constituency :

2. Date of Poll :

3. Number of the polling station :

Whether located in

a) Government or quasi-

Government building :

b) Private building :

c) Temporary structure :

4. Number of Polling Officer

Recruited locally, if any :

5. Appointment of polling officer :

Made in the absence of duly

Appointed Polling Officer, if any,

And the reasons for appointment

6. Number of ballot boxed used :

7. Number of paper seals used :

1.

2.

3.

4.

8. Number of polling agents and :

The number who arrived late

9. Number of candidates who were :

Appointed as Polling Agents at

The polling stations

10. Number of ballot papers issued :

According to marked copy of the

Electoral roll

* Number of ballot papers actually

Issued at the polling station

……………………………………………………………

Signature of the polling officer in charge of ballot papers

……………………………………………………………

Signature of First polling

11. Number of electors who voted-

a) Men ……………………………….

b) Women ………………………………

c) Total ………………………………

12. Challenged vote-

a) Number allowed ………………..

b) Number rejected ……………….

c) Amount forfeited Rs ………….

13. Number of electors who voted with :

The help of companions

14. Number of tendered votes :

15. Whether it was necessary to adjourn :

the poll and if so, the reason for such

adjournment

16. Number of votes cast

From 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 and so on :

17. Number of slips issued at the :

Closing hour of the poll

*This will include ballot papers

Cancelled and tendered ballot papers

Also.
18. Electoral offences with details :

Number of cases of –

a) Canvassing within one hundred :

Meters of a polling station

b) Impersonation of voters :

c) Fraudulent defacing, destroying or

Removal of a list of notice or other

Document at a polling station

d) Bribing of voters :

e) Intimidation of voters and other :

Persons

19. Was the poll interrupted or obstructed :

a) Riot

b) Open violence

c) Natural calamity

d) Any other cause

Please give the details of above

20. Was the vitiated by-

a) Any ballot at the polling station :

Having been unlawfully taken

Out of the custody of the presiding

Officer.

b) Accidentally or intentionally lost or :

Destroyed.
 c) Damaged or tampered with :

d) The ballot papers having been :

Unlawfully marked by any person

And deposited in ballot box.

21. Serious complaints, if any, made by :

The candidate

22. Number of cases of breach of law and :

Order

23. Report of mistakes and irregularities :

Committed,if any,at the polling station

24. Whether the declarations have been :

Made before the commencement of

The poll and if necessary during the

Course of the poll when a new ballot

Box is placed for reception of marked

Ballot paper and at the end of poll as

Neccessary.

Place:……………………………

Date:…………………………… Presiding Officer

This dairy should be forwarded to the Returning office along with

the ballot boxes and other sealed papers.