(Back of Paper)
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No. ___________________
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Constituency of ___________________
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Reifreann i dtaobh na dtograí seo a leanas:—
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Referenda on the following proposals:—
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1. _________________________________
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1. _________________________________
_________________________________
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2. _________________________________
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2. _________________________________
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3. _________________________________
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3. _________________________________
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Note: The back of each ballot paper shall be numbered consecutively and the front of the counterfoil attached to it shall bear the same number. The number on the back of the ballot paper shall be printed in the smallest characters compatible with legibility.
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