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Manual of Election Law_Volume II - Home: Chief Electoral Officer ...

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257<br />

1 [FORM 17A<br />

(See rule 49L)<br />

Register <strong>of</strong> Voters<br />

<strong>Election</strong> to the House <strong>of</strong> the People/Legislative Assembly <strong>of</strong> the State/Union territory<br />

.................................. from ................................... Constituency No. and Name <strong>of</strong> Polling<br />

Station.......................................….. Part No. <strong>of</strong> <strong>Electoral</strong> Roll......................................<br />

__________________________________________________________________________________________<br />

Sl. No. Sl. No. <strong>of</strong> elector Signature/Thumb Remarks<br />

in the electoral<br />

impression <strong>of</strong><br />

roll<br />

elector<br />

__________________________________________________________________________________________<br />

1.<br />

2.<br />

3.<br />

4.<br />

__________________________________________________________________________________________<br />

etc.<br />

___________<br />

FORM 17B<br />

(See rule 49P)<br />

List <strong>of</strong> Tendered Votes<br />

Signature <strong>of</strong> the Presiding <strong>Officer</strong>.<br />

<strong>Election</strong> to the House <strong>of</strong> the People/Legislative Assembly <strong>of</strong> the State/Union<br />

territory.......from.......Constituency.<br />

No. and Name <strong>of</strong> Polling Station......................................………………………………………………………….<br />

Part No. <strong>of</strong> <strong>Electoral</strong> Roll...........................................…………………………………………………………<br />

__________________________________________________________________________________________<br />

Sl. Name <strong>of</strong> Sl.No. <strong>of</strong> Sl. No. in Register Signature/<br />

No. elector elector in <strong>of</strong> voters Thumb<br />

electoral (Form 17A) <strong>of</strong> impression<br />

roll persons who has <strong>of</strong> elector<br />

already voted in<br />

place <strong>of</strong> elector<br />

__________________________________________________________________________________________<br />

1.<br />

2.<br />

3.<br />

4.<br />

5.<br />

6.<br />

7.<br />

8.<br />

9.<br />

10.<br />

__________________________________________________________________________________________<br />

Date.................<br />

Signature <strong>of</strong> the Presiding <strong>Officer</strong>.<br />

__________________________________________________________________________________________<br />

1. Ins. by Notifn. No. S.O. 230(E), dated the 24th March, 1992.

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