Scribd Logo
Upload

Welcome to Scribd!

  • 101 views

    FORM6

    Uploaded by

    Suji
    1) The document is an application form for inclusion of a name in the electoral roll for the first time or due to shifting from another constituency. 2) It requests inclusion in the electoral roll and provides mandatory personal particulars of the applicant such as name, age, address, relationship to relative, gender, photo, and optional details. 3) The applicant declares they are a citizen of India, ordinarily reside at the address given, and have not applied to any other constituency. They may request removal from a past constituency if applicable.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    FORM6

    Uploaded by

    Suji
    101 views2 pages
    1) The document is an application form for inclusion of a name in the electoral roll for the first time or due to shifting from another constituency. 2) It requests inclusion in the electoral roll and provides mandatory personal particulars of the applicant such as name, age, address, relationship to relative, gender, photo, and optional details. 3) The applicant declares they are a citizen of India, ordinarily reside at the address given, and have not applied to any other constituency. They may request removal from a past constituency if applicable.

    Original Description:

    election

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1) The document is an application form for inclusion of a name in the electoral roll for the first time or due to shifting from another constituency. 2) It requests inclusion in the electoral roll and provides mandatory personal particulars of the applicant such as name, age, address, relationship to relative, gender, photo, and optional details. 3) The applicant declares they are a citizen of India, ordinarily reside at the address given, and have not applied to any other constituency. They may request removal from a past constituency if applicable.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    101 views2 pages

    FORM6

    Uploaded by

    Suji
    1) The document is an application form for inclusion of a name in the electoral roll for the first time or due to shifting from another constituency. 2) It requests inclusion in the electoral roll and provides mandatory personal particulars of the applicant such as name, age, address, relationship to relative, gender, photo, and optional details. 3) The applicant declares they are a citizen of India, ordinarily reside at the address given, and have not applied to any other constituency. They may request removal from a past constituency if applicable.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    ELECTION COMMISSION OF INDIA

    FORM-6 Acknowledgement No.____________


    (See Rules 13(1) and 26) of Registration of Electors Rule-1960 (To be filled by office)
    Application for Inclusion of Name in Electoral Roll for First time Voter OR on Shifting
    from One Constituency to Another Constituency.
    To, The Electoral Registration Officer, .....Assembly / Parliamentary Consitituency
    I request that my name be included in the electoral roll for the above Constituency. (Tick appropriate box) SPACE FOR PASTING ONE
    As a first time voter or due to shifting from another constituency RECENT PASSPORT SIZE
    Particulars in support of my claim for inclusion in the electoral roll are given below:- PHOTOGRAPH (3.5 CM X
    3.5 CM) SHOWING
    Mandatory Particulars
    FRONTAL VIEW OF FULL
    (a) Name FACE WITHIN THIS BOX
    (b) Surname(if any)

    (c) Name and surname of Relative of


    Applicant [see item (d)]
    (d) Type of Relation Father Mother Husband Wife Other
    (Tick appropriate box)
    (e) Age [as on 1st January of current calendar year..] Years Months

    (f) Date of Birth (in DD/MM/YYYY format)(if known)

    (g) Gender of Applicant (Tick appropriate box) Male Female Third Gender

    (h)Current address where applicant is ordinarily resident House No.


    Street/Area/Locality
    Town/Village
    Post Office Pin Code

    District State/UT
    (i) Permanent address of applicant House No.
    Street/Area/Locality
    Town/Village
    Post Office Pin Code

    District State/UT
    (j)EPIC No. (if issued)
    Optional Particulars
    (k) Disability (if any) Visual impairment Speech & hearing disability Locomotor disability Other
    (Tick appropriate box)
    (l) Email id (optional)
    (m) Mobile No. (optional)

    DECLARATION - I hereby declare that to the best of knowledge and belief


    (i) I am a citizen of India and place of my birth is Village/Town...District..State
    (ii) I am ordinarily resident at the address given at (h) above since ..(date, month, year).
    (iii)I have not applied for the inclusion of my name in the electoral roll for any other constituency.
    *(iv)My name has not already been included in the electoral roll for this or any other assembly/ parliamentary constituency
    OR
    *My name may have been included in the electoral roll for___________________________ Constituency in _________________________
    State in which I was ordinarily resident earlier at the address mentioned below and if so, I request that the same may be deleted from that
    electoral roll.
    * strike off the option not appropriate
    Address of earlier place of ordinary residence (if applying due to shifting from another constituency)
    House No. Street/Area/Locality
    Town/Village
    Post Office Pin Code

    District State/UT
    I am aware that making a statement or declaration which is false and which I know or believe to be false or do not believe to be true, is
    punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950).

    Place..........................

    Date.. Signature of Applicant...


    Remarks of Field Level Verifying Officer:

    Details of action taken


    (To be filled by Electoral Registration Officer of the constituency)

    The application of Shri / Shrimati/ Kumari ..for inclusion of name in the


    electoral roll in Form 6 has been accepted/ rejected. Detailed reasons for acceptance [under or in pursuance of rule
    18/20/26(4)] or rejection [under or in pursuance of rule 17/20/26(4)] are given below:

    Place:

    Date: Signature of ERO Seal of the ERO

    Intimation of decision taken (to be filled by Electoral Registration Officer of the constituency and to be posted to the
    applicant on the address as given by the applicant)
    Postage Stamp to
    be affixed by the
    The application in Form 6 of Shri/Shrimati/Kumari..
    Electoral
    Current address where applicant is ordinarily resident House No. Registration
    Authority at the
    Street/Area/Locality time of dispatch
    Town/Village
    Post Office Pin Code

    District State/UT

    Has been (a) accepted and the name of Shri/Shrimati/Kumari

    Has been registered at Serial No.in Part No.. of AC No.

    (b) rejected for the reason.

    Date: Electoral Registration Officer

    Address..
    Acknowledgement/Receipt
    Acknowledgement Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date __ _ _ _ _ _ _ _ _ _ _ _ _

    Received the application in form 6 of Shri / Smt. / Ms. ___________________ ______________________________________


    [ Applicant can refer the Acknowledgement No. to check the status of application].

    Name/Signature of ERO/AERO/BLO

    You might also like