Final Cover Election Expenditure - Election Commission of India

Format for Receipt to be given to persons from whom cash/article is seizedAnnexure-57Book No………………….ReceiptNumber…………………….Date ………………………….Name of the Executive Magistrate ……………………(Heading the Flying Squad/ Static SurveillanceTeam)1. Cash Amount to …………………… (inwords………………………………………………………)/ Other articles seized…………………………………………………………are bign seized…………………………….fromShri…………………………………………………………………………..……………Address:…………………………………………………………………………..Mobile No. ………………………..………………….. at………………………………………..(name ofplace where seized) on dated………………………………………falling in theAssembly/Parliamentary Constituencyof………………………………………………………………………….(Name ofState/UT)………………… District …………………………………Police Station……………………. ……………as the entire cash/ other articles is suspected to be used asbribery of the electors.Or2. The cash Rs…………………………………………………………………………... ( In words Rs…………………………………………………)/- (details of other articles) have been handed overto Shri……………………………………...(name of the Officer of Income Tax Deptt.) takingnecessary action under Income Tax Laws. (Strike out if not applicable)You may appeal to ……………………………………………….. (Name of ADM/SDM, headingthe Expenditure Monitoring Cell) for redressal of grievance, within seven days or you may appealto Joint Director of Income Tax (Inv.) for necessary relief.Signature with Stamp(Name, Designation and address of Magistrate)Date:-177