COMUNE DI ………………………………………….………………………………………………..
Provincia di ………………………………………………………
………………………………………………………………………………………….. (1)

oggetto:	 Elenco degli scrutatori nominati in sostituzione di quelli impediti	

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

_______________
 (1) Indicare il tipo e la data della consultazione.

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio ________ ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________
3._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

Per seggio speciale ubicato presso: _____________________________________________________
sono da sostituire n. ___________ scrutatori. Vengono nominati:
1._____________________________________________________________________________________________ _______________________________________________________________________________________________
2._____________________________________________________________________________________________ _______________________________________________________________________________________________

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Il Responsabile dell’ufficio
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