If, at any time, during a period of six months from the date on which any amendment to a form for making any claim, objection or other application to the registration officer under these rules takes effect, a person makes, such claim, objection or, as the case may be, other application in the Form as it stood before such amendment, the registration officer shall deal with such claim, objection or other application and he may, for this purpose, require such person, by notice in writing, to furnish such additional information (being the information which would have been furnished if the amended Forms had been used) within such reasonable time as may be specified in the notice.]
Form 1
(See Rule 7)
Statement as to place of Ordinary Residence by a Person holding a Declared Office
Full name
51 [Father's/Mother's/Husband's name] .. ..
Age years
Office held ...
I hereby declare that I am a citizen of India and that but for my holding the above mentioned office, I would have been ordinarily resident at (full postal address) ..
I further declare that my wife (name) .
aged ..years, ordinarily
resides with me 52[and is a citizen of India].
This cancels any previous statement as to place of ordinary residence made by me.
Place ..
Date Signature
53 [Form 2
(See Rule 7)
Statement as to place of Ordinary Residence by a member of the Armed Forces
I hereby declare that I am a citizen of India and that but for my service in the Armed Forces I would have been ordinarily resident at
House No. ..
Street/Mohalla
Locality ..
Town/Village .
Post Office .
Police Station .
Tehsil/Taluka .
District
State
My full name . Rank ...
Service No. .
Service/Corps/Regiment .
Name and address of record office .
Age last birthday years Years.
*I further declare that my wife ..
age ......................... Years, ordinarily resides with me and is a citizen of India.
This cancels any previous statement as to ordinary place of residence made by me.
Date .. 199 . .
(Signature)
______________________________________________________________________________________________
Record Office Verified and found correct
Folio No (Signature) .
Place (Designation) .
Date . Officer-in-charge, Records.
______________________________________________________________________________________________
(For use in the Election Office)
Statement received on the ..199.
Registered in the electoral roll for the ..Assembly Constituency (No .). Service voters' part, at S. No. ...
Date ..199 . 54 [Electoral Registration Officer].]
______________________________________________________________________________________________
*Delete if not applicable.
55 [Form 2-A
(See Rule 7)
Statement as to place of Ordinary Residence by a member of an Armed police force of a state, who is serving outside that State
I hereby declare that I am a citizen of India and that but for my service outside the State in the armed police force mentioned below, I would have been ordinarily resident at
House No. ........... Street/Mohalla
Locality ...
Town/Village ..
Post Office ..
Police Station ..
Tehsil/Taluka ..
District
State
My full name ..
Buckle No Rank ..
Name of Armed police force ..
Name and address of the office of the Commandant ..
Age last birthday years Years.
*I further declare that my wife age ..
years, ordinarily resides with me and is a citizen of India.
This cancels any previous statement as to ordinary place of residence made by me.
Date .199 . .
(Signature)
______________________________________________________________________________________________
*Delete if not applicable.
Commandant's Office Verified and found correct.
Folio No . (Signature) .
Place (Designation) .
Date . Commandant.
______________________________________________________________________________________________
(For use in the Election Office)
Statement received on the .199.
Registered in the electoral roll for the .Assembly
Constituency (No ..). Service voters' part, at S. No .
Date 199.
..
56 [Electoral Registration Officer].]
Form 3
(See Rule 7)
Statement as to place of Ordinary Residence by a Person employed under the Government of India in a post outside India
Full Name
57 [Father's/Mother's/Husband's name] .
Age .years.
Description of post
held outside India
.
I hereby declare that I am a citizen of India and that but for my being employed under the Government of India in the above-mentioned post, I would have been ordinarily resident at (full postal address) ................
.
I further declare that my wife (name) .................................................................................
.. aged .years, ordinarily resides with the 58[and is a citizen of India].
This cancels any previous statement as to place of ordinary residence made by me.
Place Signature ..
Date .
Verified .
Signature ..
Designation of the Head of Office ..
Place ..
Date ...
______________________________________________________________________________________________
(For use in the Election Office)
Statement received on the ..199.
Registered in the electoral roll for the .
Assembly Constituency (No .. .). Service voters' part, at S.No ....................................
Date .. 59 [Electoral Registration Officer].
______________________________________________________________________________________________
Form 4
(See Rule 8)
Letter of request
Place
Date.
To
The occupant of
..
Sir/Madam,
The preparation of the electoral roll for the Assembly Constituency in which you are residing has been taken in hand. It will greatly facilitate my work if you will kindly complete the statement below after reading the attached instruction and hand it over to my assistant who will call for it.
Electoral Registration Officer of the ..
Assembly Constituency
Statement
Names and particular, of adult citizens ordinarily residing in the above premises
| Name of citizen |
Particulars as to |
60 [Father or Mother or Husband] |
61 Age on 1st January/April 19 ..] |
| 1. |
|
|
|
| 2. |
|
|
|
| 3. |
|
|
|
| 4. |
|
|
|
| 5. |
|
|
|
| 6. |
|
|
|
| 7. |
|
|
|
| etc. |
|
|
|
| |
|
|
Signature .. |
| |
|
|
Date .. |
Instructions
1. Enter the names of all persons who have completed [18 years of age on or before the 1st of January/April] of this year and who are ordinarily residing in the premises.
2. Only the names of those who are citizens of India should be entered.
3. Enter against Serial No. 1 in the first column, the name of the head or other senior member of the family, provided he or she has the qualifications mentioned in paragraphs 1 and 2 above.
4. Ordinarily residing does not mean that the person should be actually in the house when you are filling in the form. The persons who normally live in the house should be included even though they may be temporarily absent, e.g., on a journey or on business or in hospital. On the other hand, a guest or visitor, who normally lives elsewhere but happens to be in the house at the time should not be included.
5. All ordinary residents of the house should be included, whether they are members of the family or not. But do not enter the name of any person who is a member of the Armed Forces of India or is employed under the Government of India in a post outside India or the name of such person's wife if she ordinarily resides with him.
6. In the case of every male citizen, enter in the second column the name of his father preceded by the words son of
7. In the case of every female citizen, enter in the second column
(i) the name of the husband preceded by the words wife of , if she be married;
(ii) the name of the late husband preceded by the words widow of , if she be a widow; and
(iii) the name of the [Father of Mother] preceded by the words daughter of , if she be unmarried.
8. In the third column, enter the age of the citizen as accurately as possible, giving only the number of complete years and ignoring the months.
[Note: For preparation/revision of rolls in 1989, omit January and retain April . For preparation/revision of rolls in any other year, omit April and retain January ].
62 Form 5
(See Rule 10)
Notice of publication of electoral roll in draft
To
The Electors of the constituency.
Notice is hereby given that the electoral roll has been prepared in accordance with the Registration of Electors Rules, 1960, and a copy thereof is available for inspection at my office, and at ...during office hours.
The qualifying date for the preparation of the electoral roll is ...
If, with reference to the abovesaid qualifying date, there be any claim for the inclusion of a name in the roll or any objection at the inclusion of name or any objection to particulars in any entry, it should be lodged on or before the 19 .., in Form 6, 7 or 8 as may be appropriate.
Every such claim or objection should either be presented in my office or to .or sent by post to the address given below so as to reach me not later than the aforesaid date.
Electoral Registration Officer,
(Address) ]
Date ..
63 [64 [Form 6
[See Rules 13(1)and 26]
| Application for Inclusion of Name in Electoral Roll |
| To The Electoral Registration Officer, Assembly/Parliamentary Constituency. Sir, I request that my name be included in the electoral roll for the above Constituency. Particulars in support of my claim for inclusion in the electoral roll are given below : |
| I. Applicant's details |
Name |
Surname(If any) |
| |
|
|
| Age as on 1st January . . . . . . . . . . # |
Years: |
Months: |
Sex (Male/Female): |
| Date of birth, if known: |
Day: |
Month: |
Year: |
| Place of birth: |
Village/Town: |
|
| |
District: |
State: |
| *Father's |
Name |
|
Surname (If any) |
| Mother's Name |
|
|
|
| Husband's |
|
|
|
| II. |
Particulars of place of ordinary residence (Full address) |
| House/Door number: |
| Street/Area/Locality/Mohalla/Road: |
| Town/Village: |
| Post Office: |
Pin Code |
|
|
|
|
|
|
| Tehsil/Taluka/Mandal/Thana: |
| District: |
In case of Union Territories having no Legislative Assembly and the State of Jammu and Kashmir.
# Please give the year i.e. 2003, 2004, etc.
* Strike out the inappropriate alternative.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(Perforation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receipt for Application
Received the application in Form 6 of **Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . **Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . .
Signature of the officer receiving the application on
behalf of the Electoral Registration Officer
Address . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
** To be filled in by the Applicant
| III. |
Details of member(s) of applicant's family already included in the current electoral roll of the Constituency: |
| Name |
Relationship with applicant |
Part number of the roll of the constituency |
Serial number in that Part |
Elector's photo identity card (If issued) number |
| 1. |
|
|
|
|
| 2. |
|
|
|
|
| IV. Declaration I hereby declare that to the best of my knowledge and belief (i) I am a citizen of India; (ii) I am ordinarily resident at the address given in Part II above since . . . . . . . . . . . . . . (date, month, year); (iii) I have not applied for the inclusion of my name in the electoral roll for any other constitutency; (iv) *my name has not already been included in the electoral roll for this or any other assembly constitutency; 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. Full address (Earlier place of ordinary residence): |
| |
Electors photo identity card (If issued) number. . . . . . . . . ., date of issue . . . . . . . . . . |
| . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Place: Signature or thumb impression of the Applicant Date: |
Note. Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950).
* Strike out the inappropriate alternative
| Details of action taken (To be filled by Electoral Registration Officer of the Constituency) |
The application of Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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) ]:
| Place: Date: |
Signature of Electoral Registration Officer |
(Seal of the Electoral Registration Officer) |
During continuous updating after final publication of electoral roll.
* Strike out the inappropriate alternative
Form 7
[See Rule 13(2) and 26]
| Application for Objecting Inclusion or Seeking Deletion of Name in Electoral Roll |
| To The Electoral Registration Officer, Assembly/Parliamentary Constituency. Sir, @I object to the proposed inclusion of the name of the undermentioned person in the electoral roll for the above constituency. Particulars in support of my objection are given below : or @I submit that the entry relating to *myself/*the person named below is required to be deleted for the persons stated hereunder: |
| I. |
@Details of person |
Name |
Surname(If any) |
| |
inclusion of whose |
|
|
| |
name is objected to: |
Part number of electoral roll in |
His/Herserial |
Elector's photo identity card (If issued) number: |
| |
@Details of person whose entry is to be |
which his/her name is included: |
number in that part: |
|
| |
deleted: |
|
|
|
| #II. |
Details of objector |
Name |
Surname(If any) |
| |
|
|
|
| |
Sex (Male/Female): |
Part number of electoral roll in which objector's name is included: |
His/Her serial number in that part: |
| *Father's |
Name |
|
Surname (If any) |
| Mother's Name |
|
|
|
| Husband's |
|
|
|
| III. |
Particulars of place of ordinary residence of @objector/@person seeking deletion (Full address): |
| House/Door number: |
| Street/Area/Locality/Mohalla/Road: |
| Town/Village: |
| Post Office: |
Pin Code |
|
|
|
|
|
|
| Tehsil/Taluka/Mandal/Thana: |
| District: |
In case of Union Territories having no Legislative Assembly and the State of Jammu and Kashmir.
@ First alternative will be relevant during preparation/revision of electoral roll. Second alternative will be relevant during continuous updating after final publication of electoral roll. Strike out the inappropriate alternative.
* Strike out the inappropriate alternative.
# Part II not to be filled where applicant seeks deletion of entry relating to himself.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(Perforation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receipt for Application
Received the application in Form 7 of **Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . **Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . .
Signature of the officer receiving the application on
behalf of the Electoral Registration Officer
(Address) . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
** To be filled in by the Applicant
| IV. Reason(s) for *objection/*deletion: |
| V. Declatration I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge and belief. Place: Signature or thumb impression of the Applicant Date: |
Note. Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950).
* Strike out the inappropriate alternative
| Details of action taken (To be filled by Electoral Registration Officer of the Constituency) |
The application of Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *objecting to inclusion */seeking deletion of name of Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . in the electoral roll in Form 7 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) ]:
| Place: Date: |
Signature of Electoral Registration Officer |
(Seal of the Electoral Registration Officer) |
* Strike out the inappropriate alternative
During continuous updating after final publication of electoral roll.
Form 8
[See Rule 13(3) and 26]
| Application for Correction to Particulars Entered in Electoral Roll |
| To The Electoral Registration Officer, .. Assembly/Parliamentary Constituency. Sir, I request that entry relating to myself appearing in the electoral roll for the above constituency is not correct and it should be corrected. Correct particulars in support of my request are given below : |
| I. |
Applicant's Details |
Name |
Surname (If any) |
| |
|
|
|
| Part number of electoral roll: |
Serial number in that part: |
| Age as on 1st January . . . . . . # |
Years: |
Months: |
Sex (Male/Female): |
| Date of birth, if known: |
Day: |
Month: |
Year: |
| *Father's |
Name |
|
Surname (If any) |
| Mother's Name |
|
|
|
| Husband's |
|
|
|
| II. |
Particulars of place of ordinary residence (Full address) |
| House/Door number: |
| Street/Area/Locality/Mohalla/Road: |
| Town/Village: |
| Post Office: |
Pin Code |
|
|
|
|
|
|
| Tehsil/Taluka/Mandal/Thana: |
| District: |
| III. |
Details of Elector's photo identity card (If issued, in this or some other constituency) |
| Elector's photo identity card number |
| Name of the constituency: |
| IV. |
Details of entries to be corrected: *My name/*Age/*Father's/*Mother's/*Husband's name/*Sex/*Address/*Elector's photo identity card number may be corrected in terms of information provided in this Form above. |
| Place: Date: |
Signature or thumb impression of the elector |
Note. Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950).
In case of Union Territories having no Legislative Assembly and the State of Jammu and Kashmir.
# Please give the year i.e. 2002, 2003, etc.
* Strike out the inappropriate alternative.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(Perforation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receipt for Application
Received the application in Form 7 of **Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . **Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . .
Signature of the officer receiving the application on
behalf of the Electoral Registration Officer
(Address) . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
** To be filled in by the Applicant
| Details of action taken (To be filled by Electoral Registration Officer of the constituency) |
The application of Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .for correction of entry in the electoral roll in Form 8 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) ]:
| Place: Date: |
Signature of Electoral Registration Officer |
(Seal of the Electoral Registration Officer) |
* Strike out the inappropriate alternative
During continuous updating after final publication of electoral roll.
Form 8-A
[See Rules 13(4) and 26]
| Application for Transposition of Entry in Electoral Roll |
| To The Electoral Registration Officer, Assembly/Parliamentary Constituency. Sir, I request that entry in the electoral roll for the abovementioned constituency relating to *myself/*person named below should be transposed to the relevant part of the roll in this constituency. Particulars of the entry to be transposed are given below: |
| I. |
@Details of person |
Name |
Surname (If any) |
| |
whose entry is to be |
|
|
| |
transposed |
Part number of electoral roll in |
His/Her serial number in that |
Elector's photoidentity card (If |
| |
|
which his/her name is included: |
part: |
issued) number: |
| *Father's |
Name |
|
Surname (If any) |
| Mother's Name |
|
|
|
| Husband's |
|
|
|
| II. |
Particulars of present place of ordinary residence (Full address) |
| House/Door number: |
| Street/Area/Locality/Mohalla/Road: |
| Town/Village: |
| Post Office: |
Pin Code |
|
|
|
|
|
|
| Tehsil/Taluka/Mandal/Thana: |
| District: |
| III. |
Period of continuous residence at the above address on the date of application |
Years: |
Months: |
| IV. |
Part number to which the entry has to be transposed (If known): |
| @V. |
Details of applicant |
Name |
Surname (If any) |
| |
|
|
|
| |
|
Part number of electoral roll in which his/her name is included: |
His/Her serial number in that part: |
Elector's photo identity card (If issued) number: |
In case of Union Territories having no Legislative Assembly and the State of Jammu and Kashmir.
* Strike out the inappropriate alternative.
# Part V not to be filled where applicant seeks transposition of entry relating to himself.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(Perforation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Receipt for Application
Received the application in Form 8-A of **Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . **Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date . . . . . . . . . . .
Signature of the officer receiving the application on
behalf of the Electoral Registration Officer
(Address) . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . .
** To be filled in by the Applicant
| VI. Declatration I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge and belief. Place: Signature or thumb impression of the Applicant Date: |
Note. Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950).
| Details of action taken (To be filled by Electoral Registration Officer of the Constituency) |
The application of Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .for transposition of entry relating to himself/herself/Shri/Smt/Km . . . . . . . . . . . . . . . . . . . . . . . . . in the electoral roll in Form 8-A has been accepted*/rejected*.
Detailed reasons for acceptance or rejection [under Rule 26(4)]*:
| Place: Date: |
Signature of Electoral Registration Officer |
(Seal of the Electoral Registration Officer) |
* Strike out the inappropriate alternative
Form 8-B
(See Rule 26)
Application for deletion of entry in electoral roll
To
The Electoral Registration Officer,
..Assembly/Parliamentary Constituency.
Sir,
I submit that the entry relating to the person named below in the electoral roll for the above Constituency is required to be deleted for the reasons stated hereunder :
I. Details of person whose entry is to be deleted
1. Title$ .
2. First and middle name ..
3. Last name .
4. Part number of electoral roll in which his/her name is included : .
5. His/her serial number in that part :
6. Electors' Photo Identity Card number ...
II. (a) Details of relation of person whose entry is to be deleted (Father/Mother/Husband)
7. Title$ .
8. First and middle name ...
9. Last name ..
(b) Relationship with the person whose entry is to be deleted. Father/Mother/Husband:
III. Reasons for objection
(a)* Death on .
10. Day :
11. Month :
12. Year : ..
(b)* No longer ordinarily resident since
13. Day :
14. Month :
15. Year : ..
(c)* * Not entitled to be registered for the reason:
IV. (a) Objector's details :
16. Title$
17. First and middle name .
18. Last name
19. Sex (male/female) : ..
20. Part number of electoral roll in which objector's name is included : ..
21. His/her serial number in that part : ..
(b) Details of relation of objector (Father/Mother/Husband)
22. Title$
23. First and middle name .
24. Last name
(c) Relationship with objector (Father/Mother/Husband) :
V. Particulars of place of ordinary residence of objector (Full address) :
25. House/Door number :
26. Street/Mohalla/Road/Gali : ..
27. Area/Locality : ...
28. Town/Village : .
29. Post Office : .
30. Pin Code :
31. Police Station : .
32. Tehsil/Taluka@ : ..
33. Block/Mandal (for Village)@ : ...
34. District : ...
_______________________________________________________________________________________________________________________________________________________
$ Sh./Smt/Km./Dr. etc.
@ May not be applicable in Metropolitan Areas
In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir
@ Strike out the inappropriate alternative
VI. Details of objector's Photo Identity Card, if issued, in this or in any other Constituency
35. Electors' Photo Identity Card number : ..
36. Date of issue : ..
37. Constituency (Assembly/ Parliamentary Constituency) number : ..
Name : ..
VII. Declaration
I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge and belief.
Place : ..
Date :
I am submitting the application to the Electoral Registration Officer through
Sh./Smt./Km. (full name and address) .. .. ..
.
Signature or thumb impression of objector
Or (ii) in person*,/or (iii) by Post*
Signature or thumb impression of objector
Note Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under section 31 of the Representation of the People Act, 1950.
______________________________________________________________________________________________
* Strike out the inappropriate alternative.
In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir.
Signature or thumb impression of the
person submitting the application
For use of registration officer or other officer designated by him
Details of acknowledgement
(To be filled by Officer receiving the application)
Details of acknowledgement receipt issued to the applicant.
Receipt number : . Signature of officer
Date of receipt : receiving the application .
Remarks, if any, of the Officer receiving the application :
...
Application received by :
Name of Officer : ..
Designation * : ..
Place : . Signature of officer
Date : .. receiving the application .
______________________________________________________________________________________________
* Electoral Registration Officer/Assistant Electoral Registration Officer
Details of action taken
(To be filled by electoral registration officer of the constituency)
Revision identity
Constituency number and name
The application of *Shri/*Smt./*Km. .. for transposition of entry relating to *Shri/*Smt./*Km. ..in the electoral roll in Form 8B has been accepted*/rejected*
*Accepted :
Under rule 26(4) and relevant entry is deleted in the electoral roll of the Constituency
Serial number of entry deleted .. .
In part number ...
*Rejected :
Rejected, under rule 26(4) ...
Detailed reasons for acceptance or rejection [under rule 26(4)] : ..
..
Place : . .
Date : .. (Seal of Electoral Registration Officer)
Signature of Electoral Registration Officer
______________________________________________________________________________________________
* Strike out the inappropriate alternative.
Form 9
(See Rules 15 and 16)
Designated location identity
(where applications have been received)
List of applications for inclusion of names received in Form 6
Revision identity
Constituency (Assembly/Parliamentary Constituency):
1. List number@
2. Period of receipt of applications (covered in this list) ...
From date .
To date ..
3. Place of hearing* ...
| Serial number of application |
Date of receipt |
Name of claimant |
Name of Father/Mother/ Husband and (Relationship)# |
Place of residence |
Date of hearing* |
Time of hearing* |
| 1 |
2 |
3 |
4 |
5 |
6(a) |
6(b) |
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Date of exhibition at designated location under rule 15(b) ...
Date of exhibition at Electoral Registration Officer's Office under rule 16(b) .
______________________________________________________________________________________________
In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir
@ For this revision for this designated location
* Place, time and date of hearing as fixed by electoral registration officer
Running serial number is to be maintained for each revision for each designated location
# Give relationship as F=Father, M=Mother and H=Husband within brackets i.e. (F), (M), (H)
Form 10
(See Rules 15 and 16)
Designated location identity
(where applications have been received)
List of applications for objection to inclusion of names received in Form 7
Constituency (Assembly/Parliamentary Constituency):
1. List number@ : ...
2. Period of receipt of applications (covered in this list) ...
From date ..........
To date ..............
3. Place of hearing* :
| Serial number of application |
Date of receipt |
Name (in full) of objector |
Particulars of name objected to |
Reasons in brief for objection |
Date of hearing* |
Time of hearing* |
| |
|
|
Part number |
Serial number |
Name in full |
|
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| 1 |
2 |
3 |
4 |
5 |
6 |
7 |
8(a) |
8(b) |
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Date of exhibition at designated location under rule 15(b) ...
Date of exhibition at Electoral Registration Officer's Office under rule 16(b) .
______________________________________________________________________________________________
In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir
@ For this revision for this designated location.
* Place, time and date of hearing as fixed by electoral registration officer.
Running serial number is to be maintained for each revision for each designated location
Form 11
(See Rules 15 and 16)
Designated location identity
(where applications have been received)
List of applications for objection to particulars in entries in electoral roll received in Form 8
Revision identity
Constituency (Assembly/Parliamentary Constituency):
1. List number@ : ...
2. Period of receipt of applications (covered in this list) ...
From date ..........
To date ..............
3. Place of hearing* :
| Serial number of application |
Date of receipt |
Name (in full) of elector objecting |
Particulars of entry objected to |
Nature of objection |
Date of hearing* |
Time of hearing* |
| |
|
|
Part number |
Serial number |
|
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| 1 |
2 |
3 |
4 |
5 |
6 |
7(a) |
7(b) |
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Date of exhibition at designated location under rule 15(b) ...
Date of exhibition at Electoral Registration Officer's Office under rule 16(b) .
______________________________________________________________________________________________
In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir
@ For this revision for this designated location.
* Place, time and date of hearing as fixed by electoral registration officer.
Running serial number is to be maintained for each revision for each designated location]
Form 13
[See Rules 19(1)(b)(ii)]
Notice to the objector
Duplicate
..
(Office Copy)
To
(Full name .........................................................................................................................................................
and address .........................................................................................................................................................
of objector) .........................................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that your objection to the inclusion of the name of
will be heard at........................................... (place) at........................................... O'clock on the........................... day of....................................................19 . Your are directed to be present at the hearing with such evidence as you/may like to adduce:
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
Registration of Electors Rules, 1960
Form 13
[See Rules 19(1)(b)(ii)]
Notice to the objector
Original
..
(To be served on the objector)
To
(Full name .........................................................................................................................................................
and address .........................................................................................................................................................
of objector) .........................................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that your objection to the inclusion of the name of
will be heard at........................................... (place) at........................................................... O'clock on the........................... day of....................................................19 . You are directed to be present at the hearing with such evidence as you may like to adduce:
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
______________________________________________________________________________________________
Certificate of Service of notice
Received notice of the date of hearing
Date..........................................................
.. ...............................................
Objector
Certified that the notice on the objector has been duly served by me this...........................................................day of .on (name).......................................................personally/by affixation on residence.
Place.............................................................
Date..............................................................
Serving Officer.
______________________________________________________________________________________________
N.B. If this notice is served by post, attach the receipt here.
Form 14
[See Rules 19(1)(b)(ii)]
65 [Notice to the person in respect of whomobjection has been made]
Duplicate
..
(Office Copy)
To
(Full name .......................................................................................................................................
and address of person .......................................................................................................................................
objected of) .......................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that objection to the inclusion of your name at Serial No. . in Part......................................................of the electoral roll for.....................................................................constituency filed by
(Full name .......................................................................................................................................
and address of .......................................................................................................................................
objected) .......................................................................................................................................
will be heard at........................................... (place) at........................................... O'clock on the........................... day of....................................................19 . You are directed to be present at the hearing with such evidence as you/may like to adduce. The grounds of objection (in brief)
(a)
(b)
(c)
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
Registration of Electors Rules, 1960
Form 14
[See Rules 19(1)(b)(ii)]
[Notice to the person in respect of whomobjection has been made]
Original
(To be served on the person objected to)
To
(Full name .......................................................................................................................................
and address of person .......................................................................................................................................
objected of) .......................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that the objection to the inclusion of your name at Serial No. in Part......................................................of the electoral roll for.....................................................................constituency filed by
(Full name .......................................................................................................................................
and address of .......................................................................................................................................
objected) .......................................................................................................................................
will be heard at........................................... (place) at........................................... O'clock on the........................... day of....................................................19 . You are directed to be present at the hearing with such evidence as you/may like to adduce. The grounds of objection (in brief) are:
(a)
(b)
(c)
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
______________________________________________________________________________________________
Certificate of Service of notice
Received notice of the date of hearing
Date..........................................................
.. ...............................................
Person objected to
Certified that the notice on the person, the entry relating to whose name has been objector to, has been duly served by me this ................................................day of.......................................................... .on (name).......................................................personally/by affixation on residence.
Place.............................................................
Date..............................................................
Serving Officer.
_____________________________________________________________________________________________
N.B. If this notice is served by post, attach the receipt here.
Form 15
[See Rules 19(1)(b)(iii)]
Notice of hearing of an objection to particulars in an entry
Duplicate
..
(Office Copy)
To
(Full name .......................................................................................................................................
and address of .......................................................................................................................................
objector) .......................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that your objection to certain particulars in the entry relating to you will be heard at .. .(place) at ..O'clock on the day of 19 . You are directed to be present at the hearing with such evidence as you may like to adduce.
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
Registration of Electors Rules, 1960
Form 15
[See Rules 19(1)(b)(iii)]
Notice of hearing of an objection to particulars in an entry
Original
..
(To be served on the objector)
To
(Full name .......................................................................................................................................
and address of .......................................................................................................................................
objector) .......................................................................................................................................
Reference: Objection No. .. .................................................................
Take notice that your objection to certain particulars in the entry relating to you will be heard at .. .(place) at ..O'clock on the day of 19 . You are directed to be present at the hearing with such evidence as you may like to adduce.
Place.........................................................
Date..........................................................
.....................................................
Electoral Registration Officer.
______________________________________________________________________________________________
Certificate of Service of notice
Received notice of the date of hearing
Date..........................................................
.. ...............................................
Objector
Certified that the notice on the objector has been duly served by me this..............................................day of........................................................on (name)...........................................personally/by affixation on residence.
Place.............................................................
Date..............................................................
Serving Officer.
_____________________________________________________________________________________________
N.B. If this notice is served by post, attach the receipt here.
66 [Form 16
[See Rule 22(1)]
Notice of final publication of electoral roll
It is hereby notified for public information that the list of amendments to the draft electoral roll for the.................................................... constituency has been prepared with reference to..................................................as the qualifying date and in accordance with the Registration of Electors Rules, 1960. A copy of the said roll together with the said list of amendments has been published and will be available for inspection at my office.
Place..............................................................
Date...............................................................
(Address).......................................................
..........................................]
.........................................................................
Electoral Registration Officer
Form 17
[See Rule 30]
Application for inclusion of name in the electoral roll for a local authorities' constituency
To
The Electoral Registration Officer,
..................................................................... (Local Authorities) Constituency.
Sir,
I am a member of............................................................which is a constituent local authority exercising jurisdiction within the limits of the ........................................local authorities' constituency. I am therefore entitled to be registered as an elector in the said constituency, and request that my name be included in the electoral roll thereof.
My address is: ..
..........................................
..........................................
.........................................................................
Yours faithfully
67 [Form 18
[See Rule 31]
Claim for inclusion of name in the electoral roll for a graduates' constituency
To
The Electoral Registration Officer,
..................................................................... (graduate) Constituency.
Sir,
I request that my name be registered in the electoral roll for the ....................(graduate's) Constituency.
The particulars are:
Name (in full)................................................................................... Sex ..................................................................
Father's/Mother's/Husband's name (in full) .............................................................................................................
Qualification ..............................................................................................................................................................
Occupation .................................................................................................................................................................
House address (Place of ordinary residence) :
House No. ..................................................................................................................................................................
Street/Mohalla ...........................................................................................................................................................
Town/Village .............................................................................................................................................................
Post Office .................................................................................................................................................................
Police Station/Tehsil/Taluka/Mouza .........................................................................................................................
District .......................................................................................................................................................................
Age .............................................................................................................................................................................
2. *I am a graduate of the .....................University having passed the degree/diploma examination in the year...............................................................................
OR
*I am in possession of a diploma/certificate in ...........................................which is a qualification equivalent to that of a graduate of a University in India having passed the examination for the diploma certificate in the year....................................................................................
3. In support of my claim as being a graduate/in possession of the above diploma/certificate. I submit herewith....................................................................................
4. **My name has not been included in the electoral roll for this or any other graduates' constituency.
OR
**My name has been included in the electoral roll for the .........................graduates' constituency under the address given below and I request that it be deleted from that roll:
...........................................
....................................................................................................................................................................................
5. I declare that I am a citizen of India and that all the particulars given above are true to the best of my knowledge.
Place................................................................
Date.................................................................
.................................
Signature of claimant.
Note : Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act, 1950.
.. ........................................................(Perforation)..................................................................................
Intimation of action taken
The application in Form 18 of Shri/Shrimati/Kumari................................address...............................................has been
(a) accepted and the name of Shri/Shrimati/Kumari.................................................... has been registered at Serial No ....................... in Part No...................................
(b) rejected for the reason...........................................................................................................................................
Date..................................................................
Electoral Registration Officer
(Adress).............................................................
...........................................................................
...........................................................................
..........................................................(Perforation)..............................................................................
Receipt for application
Received the application in Form 18 from Shri/Shrimati/Kumari*...........................................................................
address*......................................................................................................................................................................
Date....................................................................
Electoral Registration Officer
(Address).............................................................
.............................................................................
.............................................................................
__________________________________________________________________________________________
*Strike out the paragraph not applicable.
**Strike off the inappropriate alternative.
*To be filled in by the applicant.
68 [Form 19
[See Rule 31]
Claim for inclusion of name in the electoral roll for a teachers' constituency
To
The Electoral Registration Officer,
..................................................................... (Teachers') Constituency.
Sir,
I request that my name be registered in the electoral roll for the ....................(teachers') Constituency.
The particulars are:
Name (in full)................................................................................... Sex ..................................................................
Father's/Mother's/Husband's ............................................................ name ........................................................ (in full)................................................................................................................
House address (Place of ordinary residence):
House No. ..................................................................................................................................................................
Street/Mohalla ...........................................................................................................................................................
Town/Village .............................................................................................................................................................
Post Office .................................................................................................................................................................
Police Station/Tehsil/Taluka/Mouza .........................................................................................................................
District .......................................................................................................................................................................
Age .............................................................................................................................................................................
2. During the last six years I have been engaged in teaching for a total period of more than three years as follows:
Name of Educational Institution From (Date) To (Date) Period
1.
2.
3.
4.
In support of the above I submit herewith .................................................................................................................
................................................................................................................................
....................................................................................................................................................................................
3. *My name has not been included in the electoral roll for this or any other teachers' constituency.
OR
*My name has been included in the electoral roll for the........................................teachers' constituency under the address given below and I request that it be deleted from that roll:
....................................................................................................................................................................................
....................................................................................................................................................................................
....................................................................................................................................................................................
4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my knowledge and belief.
Place....................................................................
Date.....................................................................
.................................
Signature of claimant.
Note : Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act, 1950.
. .................................(Perforation).................................................................................
Intimation of action taken
The application in Form 19 of Shri/Shrimati/Kumari
Address ..................................... has been
(a) accepted and the name of Shri/Shrimati/Kumari................................................................... has been registered at Serial No ........................... in Part ............................. No.....................................................
(b) rejected for the reason...........................................................................................................................................
Date.......................................................................
Electoral Registration officer
(Address)................................................................
................................................................................
................................................................................]
. .................................(Perforation).................................................................................
Receipt for application
Received the application in Form 19 from Shri/Shrimati/Kumari*...........................................................................
address*......................................................................................................................................................................
Date............................................................................
Electoral Registration Officer
(Address).....................................................................
.....................................................................................
..]
______________________________________________________________________________________________
**Strike out the paragraph not applicable.
*To be filled in by the applicant.