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Form 6 7

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imran_akhter22
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53 views2 pages

Form 6 7

this is demo

Uploaded by

imran_akhter22
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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8/2/13 FORM-6

123.176.47.59/ERMS/Postal/userdetails.aspx 1/2
Application for inclusion of name in electoral roll ApplicationID:06036354
To,
The Electoral Registration Officer
*Assembly Constituency: Khairatabad
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: NAZIYA .a: -a
Surname(if any): PARVEEN .a: o_'
Date of birth if you know: Day:15 Month:05 Year:1987 Gender: F
Age as on 1st January 2013: Year:25 Months:7
Place of birth Place of birth
Village/ Town: HYDERABAD
District: RANGA REDDY State: ANDHRA PRADESH
Relation Details
Relation Type
Father's/Mother's/Husband's:
H
Name: NAUSHAD .a: -``c
Surname(if any): ALAM .a:
II. Particulars of place of present ordinary Residence(Full address)
House/Door number: 1-11-58/10/C
Street /Area /Locality
/Mohalla /Road:
BEGUMPET
Dc /o/
's0:
.e
Town/ Village: HYDERABAD /n : coc
Tehsil/ Taluka/Mandal/
Thana:
KHAIRATABAD SHAIKPET
HIMAYATHNAGAR
c /: cc cs_ c_
District: HYDERABAD Post Office: BEGUMPET
Pin code: 500016
III. Details of member(s) of applicant's family already included in the current electoral roll of the Constitutency:
8/2/13 FORM-6
123.176.47.59/ERMS/Postal/userdetails.aspx 2/2
Name:
Relationship with
applicant:
RPart number of the
roll of the
Constitutency:
Serial number in the
Part:
Elector's Photo Identity Card
Number:
1. 0 0
2. 0 0
Mobile No: 9550667804 Remarks:
Email-Id: [email protected]
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