MODEL – 02 K.A.P
KËRKESË ANKIMORE
Drejtuar: Komisionit Qëndror të Zgjedhjeve
Adresa: Rruga” Ibrahim Rugova”, Ndertesa nr.4: Tiranë
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ANKUESI
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Subjekti Ankues |
Adresa dhe/ose nr. i telefonit |
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OBJEKTI
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1.Kërkesë për shpalljen e pavlefshme të zgjedhjeve në: |
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QV nr ___, QV nr._____ QV nr.___, etj
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Njësia Zgjedhore Bashkia_______________ | |||
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2.Kundërshtimi i Vendimit të KZAZ/KQZ
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| Vendimi | Titulli i Vendimit | |||
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Nr. |
Datë |
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| ____ | ___/___/19 | |||
| 3.Kundërshtimi ndaj mosmarrjes vendim prej KZAZ-së | ||||
| Bazuar në nenin 124 dhe 126, neni 160, pika 2 dhe 3, neni 161, pika 1 të Kodit Zgjedhor të Republikës së Shqipërisë | ||||
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SHKELJA E PRETENDUAR DHE PASOJA E TYRE
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________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ —————————————— Nënshkrimi i anketuesit |
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FAKTET, ARGUMENTAT, DISPOZITAT LIGJORE KU MBËSHTETET ANKIMI.
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________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ —————————————— Nënshkrimi i anketuesit |
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PROVAT QË PARAQITEN DHE /OSE KËRKOHEN SI DHE NUMRI I TYRE.
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Bashkëlidhur Vendimi nr.__, date __.__.2019
ANKUESI
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___/___/2019
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Nënshkrimi i anketuesit
