13.07.2015 Views

Handbook for Electoral Registration Officers - Election Commission ...

Handbook for Electoral Registration Officers - Election Commission ...

Handbook for Electoral Registration Officers - Election Commission ...

SHOW MORE
SHOW LESS
  • No tags were found...

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

ToANNEXURE 5.1bCHAPTER V, PARA 5FORM 6A(see rule 8B)Application <strong>for</strong> inclusion of name in electoral roll by an overseas electorThe <strong>Electoral</strong> <strong>Registration</strong> Officer,……………………..Assembly/ParliamentaryConstituency.………………………………………….District:………………………………..State in India…………………………….Space <strong>for</strong> pastingOne recent passportsize photograph(3.5 CM X 3.5 CM)Showing frontal view offull face within this box.Sir,I request that my name be included in the electoral roll <strong>for</strong> the Constituencyin which my place of residence, as per the particulars furnished below in 1(h), islocated.PART - A1. Particulars in support of my claim <strong>for</strong> inclusion in the electoral rollare given below:(a) Name - ………………(b) Middle Name...............(c)Surname ..................(d) Date of Birth: --- Day---Month---Year(e) Sex(Male/Female) ..........(f) Place of Birth –i_. Village/Town................ii. District............iii. State.. .. .. .. .. .. .. .. .. ..(g) Father's/Mother's/Husband's detailsi. Name -........................ .ii. Middle Name ……………..iii. Surname...............(h) Place of Ordinary Residence in India (Full Address asgiven in the Passport)i. House/Door number. . . . . . . . . . . .ii. Street/Area/Locality/Mohalla/Road ……..,iii. Town/Village..................iv. Post Office ...................v. Pin Code .....................vi. Tahsil/Taluka/MandaI/Thana.........................vii. District. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..(i) Passport Details -i. Passport Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ii. Place of Issue of current IndianPassport. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iii. Date of Issue of current Indianpassport. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iv. Date of expiry of current Indianpassport……………………………………………………171

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!