In the Matter of the Chief Executive Election Ordinance (Cap 569) and
*In the Matter of a *subsector ordinary election/subsector by-election for the (name of subsector) subsector held on (date of election).
(or)*In the Matter of a *sub-subsector ordinary election/sub-subsector by-election for the *sports/performing arts/culture/publication sub-subsector held on (date of election).
To: Revising Officer
I, (name to be stated), holder of an identity card issued under the Registration of Persons Ordinance (Cap 177), (number to be stated) state-
1. (a) that I was a candidate at the above-mentioned election;
*(b) in an election which was not contested, that *(name of candidate) was a candidate at the above-mentioned election/(name of each candidate) were candidates at the above-mentioned election, and on (date on which the candidate was declared elected or the candidates were declared elected) the Returning Officer for the above-mentioned *subsector/sub-subsector declared in a notice published in accordance with regulations made under section 7 of the Electoral Affairs Commission Ordinance (Cap 541) that *that candidate/those candidates *was/were elected for the above-mentioned *subsector/sub-subsector;
*(b) in a contested election, that the poll was held on the above day, that (name of each candidate) were candidates at the above-mentioned election, and on (date on which the successful candidate was declared elected or the successful candidates were declared elected) the Returning Officer for the above-mentioned *subsector/sub-subsector declared in a notice published in accordance with regulations made under section 7 of the Electoral Affairs Commission Ordinance (Cap 541) that *(name of successful candidate)/(names of successful candidates) *was/were elected for the above-mentioned *subsector/sub-subsector;
(c) that (ground under section 3(3) of the Election Committee (Appeals) Regulation (Cap 569 sub. leg.A) on which the election is questioned and the facts on which the appellant relies).
2. I therefore request the Revising Officer to determine whether the *candidate/candidates (to be named) declared by the Returning Officer for the above-mentioned *subsector/sub-subsector in accordance with regulations made under section 7 of the Electoral Affairs Commission Ordinance (Cap 541) to have been elected *was/were duly elected.
Dated this ............ day of ..................... 20 ........
Signed
Appellant
The address for service is (address to be stated).
*Delete whichever is inapplicable.