FORM NO. III

{See Rule 14(4)}

DECLARATION PAPER

Election to the Council of Architecture under clause (c) of sub-section (3) of section 3

Serial No..........................................................................................................................................

Elector's Name.................................................................................................................................

Name of the Architectural Institution headed by the elector................................................................

(Elector's declaration)

I, .......................................................... (Name in full, and designation, if any), declare that I am an elector for the election of a member, to the Council of Architecture and that I have signed no other voting paper at this election.

     Station........................................................

     Date ..........................................................

Signature