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Wednesday, 01 September 2010 05:30

Download Application for Correction to Particulars Entered in Electoral Roll

Download forms for state: Jharkhand
Form Details
StateJharkhand
DepartmentCabinet secretariat & coordination
TitleApplication for Correction to Particulars Entered in Electoral Roll
LanguageEnglish
Document Size429.8 KB
Text of the PDF document(for quick reference)
FORM 8 To House/Door number: Street / Area / Locality / Mohalla / Road: Town/Village: Post Office: Pin Code: Tehsil/Taluka/Mandal/Thana: District: Published on National Portal of India (india.gov.in) Sir, I. Applicant 's details Name Surname (if any) Age as on 1st January Years:# Months: Father's Mother's Husband's Name * Date of Birth, if known Sex Female Male Assembly/Parliamentary £ Constituency The Electoral Registration Officer, Surname (if any)Name £ 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. II. Particulars of place of ordinary residence (Full address): Yes No GOVERNMENT OF JHARKHAND DEPARTMENT OF CABINET SECRETARIAT & CO-ORDINATION APPLICATION FOR CORRECTION TO PARTICULARS ENTERED IN ELECTORAL ROLL [See rules 13(3) and 26] 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: Part number of electoral roll: Serial number in that part: 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. Date: Place: 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). 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: Details of action taken (To be filled by Electoral Registration Officer of the constituency) The application of correction of entry 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)]£ *rejection [under or in pursuance of rule 17*/20* 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. Date: Place: Shri/ Smt./ Km Published on National Portal of India (india.gov.in) / 26(4)£ ]: **Address Date Signature of the officer receiving the application on behalf of the Electoral Registration Officer (Address) ** To be filled in by the applicant. (Perforation) Receipt for application Received the application in Form 8 of **Shri/Shrimati/Kumari
Last Updated on Friday, 17 December 2010 05:30
 

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