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FORM-6 Voter Application

Venkatakalyana Madala applies for inclusion in the electoral roll for the Tenali Assembly Constituency. He provides details of his name, date of birth, age, place of birth, father's name, current address, and that his father and mother are already included in the current electoral roll for the constituency. He requests that his name be added to the electoral roll.

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76 views2 pages

FORM-6 Voter Application

Venkatakalyana Madala applies for inclusion in the electoral roll for the Tenali Assembly Constituency. He provides details of his name, date of birth, age, place of birth, father's name, current address, and that his father and mother are already included in the current electoral roll for the constituency. He requests that his name be added to the electoral roll.

Uploaded by

mvnaylak6
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Application for inclusion of name in electoral roll ApplicationID:AP091108302

To,

The Electoral Registration Officer

*Assembly Constituency: Tenali


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: VENKATAKALYAN 塛�ర塚�: 韀�ంక క ణ

Surname(if any): MADALA ఇంట 塛�ర塚�: ల


Date of birth if you know: Day:20 Month:09 Year:1995 Gender: M

Age as on 1st January


Year:21 Months:3
2017:

Place of birth Place of birth

Village/ Town: TENALI

District: GUNTUR State: ANDHRA PRADESH

Relation Details

Relation Type
F
Father's/Mother's/Husband's:

Name: NIVAS 塛�ర塚�: స

Surname(if any): MADALA ఇంట 塛�ర塚�: ల

II. Particulars of place of present ordinary Residence(Full address)

House/Door number: 14­54­8

Street /Area /Locality RR NAGAR 5TH LINE 4TH CROSS , 妤�㈩럀� /ఏ桬�య /
/Mohalla /Road: MORRISPET ల𬷿ကా揁�ట: 韀� 韀� నగ韀� 5th ఈన 4th 韀�韀�స , 韀�韀� ట

Town/ Village: TENALI పట贃 ణం/ကాퟥ�మం: 韀�

Tehsil/ Taluka/Mandal/
TENALI ㈮ ల៝�క /మండలం: 韀�
Thana:

District: GUNTUR Post Office: INDIAN POST OFFICE

Pin code: 522201

III. Details of member(s) of applicant's family already included in the current electoral roll of the Constitutency:

Name: Relationship with RPart number of the Serial number in the Elector's Photo Identity
applicant: roll of the Part: Card Number:
Constitutency:
1. MADALA NIVAS FATHER 0 0
2. MADALA DHANA LAKSHMI MOTHER 0 0
Mobile No: 9505556879 Remarks:
Email­Id: [email protected]
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