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SCHEDULELAND REFORM (SCOTLAND) ACT 2003

BALLOT RETURN FORM

1.  Name of crofting community body.

2.  Date of ballot.

3.  Question which was put to the ballot.

4.  Result of vote.

5.  Number of persons eligible to vote.

6.  Number of those persons who are tenants of crofts within the land which the crofting community body proposes to buy.

7.  Number of persons who voted (including details of the number of proxy votes cast) and the number of those persons who are such tenants.

8.  Number of persons who voted in favour of the proposal to buy and the number of those persons who are such tenants.

9.  Name, address and telephone number of crofting community body representative making the ballot return.