FORM 3N.I.
Form of declaration as to expenses required by section forty-one to be authorised by an election agent.N.I.
Election in the....................................................................................................constituency
[F1 or................................................................................[F2 district electoral area]],
Date of publication of notice of election........................................................................................................................
I hereby declare that—
1. I am the person [ or a director, general manager, secretary or other like officer of the association or body of persons] named as incurring expenses in the accompanying return, marked........................................, of expenses required by section forty-one of the Electoral Law Act (Northern Ireland), 1962, to be authorised by an election agent.
2. To the best of my knowledge and belief the said return is complete and correct.
3. The matters for which the expenses referred to in the said return were incurred were as follows................................................................................
Signature of declarant............................................................
Office held by declarant................................................................................
(in the case of an association or body of persons)
Date........................................