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Regulation 7

SCHEDULELAND REFORM (SCOTLAND) ACT 2003

BALLOT RETURN FORM

1.  Name of community body.

2.  Registration number in Register of Community Interest in Land.

3.  Date of ballot.

4.  Question which was put to the ballot.

5.  Result of vote.

6.  Number of persons eligible to vote.

7.  Number of eligible persons who voted, including details of the number of proxy votes cast.

8.  Number of eligible persons who voted in favour of buying the land proposed to be purchased.

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