Hkkjr fuokZpu vk;ksx QkeZ&8 - Uttarakhand

1 Hkkjr fuokZpu vk;ksx ELECTION COMMISSION OF INDIA. QkeZ&8 FORM-8. [fuokZpd jftLV fu;e 1960 dk fu;e 13 2 vkSj 26 nsf[k,]. (See Rules 13(2) and 26) of Registration of Electors Rule-1960. ikorh la[;k------------------------ Acknowledgement dk;kZy; n~okjk Hkjk tk,xk (To be filled by office). fuokZpd ukekoyh esa izfo"V fof'kf"V;ksa dh 'kqf) ds fy, vkosnu Application for Correction to Particulars Entered in Electoral Roll lsok es]a iwjs psgjs dks lkeus ls minf'kZr djrs fuokZpd jftLV vkfQlj] gq, uohure QksVks ( CM X .. lHkk fuokZpu {ks=@ lalnh; fuokZpu {ks=A CM) fpidkus ds fy, LFkku SPACE. FOR PASTING ONE RECENT. PASSPORT SIZE PHOTOGRAPH. To, ( CM X CM) SHOWING.}}

2 The Electoral Registration Officer, FRONTAL VIEW OF FULL..Assembly / Parliamentary Constituency FACE WITHIN THIS BOX if correction in photograph eSa fuosnu djrk gWw fd mijksDr fuokZpu {ks= dh fuokZpd ukekoyh esa vkus okyh eq>ls lacaf/kr izfof"V. 'kq) ugh gS vkSj bls 'kq) dj fn;k tk,A. I request that entry relating to myself appearing in the electoral roll the above Constituency is not correct and it should be corrected. d uke (a) Name [k miuke ;fn dksbZ gks . (b) Surname(if any). x fuokZpd ukekoyh ds lkFk jftLV ds C;kSjs fo/kku lHkk@lalnh; fuokZpu {ks= dk uke (c) Details of registration with electoral roll Name of Assembly/ Parliamentary Constituency fuokZpd ukekoyh dh Hkkx la[;k fuokZpd ukekoyh dh dze la[;k Part No.]]]}}

3 Of Electoral Roll Serial No. of Electoral Roll ?k bZihvkbZlh la0 ;fn tkjh dh xbZ gks . (d) EPIC No. (If issued). M- d`Ik;k lgh dh tkus okyh izfof"V ij fu'kku yxk,a (e) Please tick the entry which is to be corrected uke QksVks bZihvkbZlh irk tUe dh rkjh[k Name Photograph EPIC Address Date of Birth vk;q laca/kh dk uke laca/k dk izdkj fyax Age Name of Relative Type of Relation Gender 'kq) dh tkus okyh izfof"V esa 'kq) fof'kf"V;ka uhps nh xbZ gS%&. The correct particulars in entry to be corrected are as below:- p bZ&esy vkbZ Mh oSdfYid . (g) Email id (optional). N eksckbZy la[;k oSdfYid . (h) Mobile No. (optional). eq>s Kku gS fd ,slk dFku djuk ;k ?]]

4 Kks" djuk tks vlR; gS vkSj ftls eSa tkurk gWw ;k fo'okl djrk gWw fd vlR; gS ;k ftlds lR;. gksus ij eSa fo'okl ugha djrk gWw] og yksd izfrfuf/kRo vf/kfu;e]1950 1950 dk 43 dh /kkjk 31 ds v/khu naMuh; gSA. I am aware that making a statement or declaration which is false and which I know or believe to be false or do not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of 1950). LFkku Place fnukad Date vkosnd ds gLrk{kj-------------------------------- signature of Applicant .. {ks= Lrjh; lR;kiu vf/kdkjh dh Remarks of Field Level Verifying Officer: dh xbZ dk;Zokgh ds C;kSjs fuokZpu {ks= ds fuokZpd jftLV vkWfQlj }kjk Hkjk tkuk.}}

5 Details of action taken (To be filled by Electoral Registration Officer of the constituency). iz:Ik 8 esa fuokZpd ukekoyh esa izfo"V dh 'kqf) ds fy, Jh@Jherh@dqekjh------------------------- ---------------------------------------- ------------------------------------dk vkosnu Lohd`r@ukeatwj dj fn;k x;k gSA [ fu;e 18@20@26 4 ds v/khu ;k esa] Lohdkj djus ;k fu;e 17@20@26 4 ds v/khu ;k esa]. ukeatwj djus ds fy, foLr`r uhps fn, x, gS%. The application of Shri / Shrimati/ Kumari for correction of entry in the electoral roll in Form 8 has been reasons for acceptance [under or in pursuance of rule 18/20/26(4)] or rejection [under or in pursuance of rule 17/20/26(4)] are given below: LFkku Place fnukad Date fuokZpd jftLV vkfQlj ds gLrk{kj fuokZpd jftLV vkfQlj dh eqnzk Signature of ERO Seal of the ERO.}

6 Fd, x, fofu'p; dh lwpuk fuokZpu {ks= ds fuokZpd jftLV vkfQlj }kjk Hkjk tkuk gS vkSj vfHkys[k esa miyC/k@vkosnd fn, x, irs ij Mkd }kjk Hkstk tkuk gS . Intimation of decision taken (to be filled by Electoral Registration Officer of the constituency and to be posted to the applicant on the address as available in records/given by applicant). Jh@Jherh@dqekjh ---------------------------------------- ---------------------------------------- ------------- dk iz:i 8 esa vkosnu fuokZpd izkf/kdkjh }kjk iz"s ds The application in Form 8 of Shri/Shrimati/Kumari le; Mkd fVdV pLik fd, tkus gSa Postage Stamp to be affixed by the Electoral orZeku irk] ftl ij vkosnd ekewyh :i ls fuokl djrk gS x`g la- Registration Current address where applicant is ordinarily resident Authority at the House No.

7 Time of dispatch xyh@{ks=@LFkku Street/Area/Locality 'kgj@xzke Town/Village Mkd ?kj Post Office fiudksM Pin Code ftyk District jkT;@la?k jkT;. {ks= State/UT. d Lohdkj dj fy;k x;k gS vkSj lHkk fuokZpu {ks= la0------------------------------------- --------------- ds Hkkx la0------------------------------------- -dh dze la0------------------------------------- ----dks rnuqlkj-----------------------------mika rfjr dj fn;k x;k gSA. Has been (a) accepted and the entry at Sr. No ..of Part of AC No .. has been modified accordingly [k ---------------------------------------- ---------------------------------------- ---------------------------------------- ------------------------------------- ls vLohd`r dj fn;k x;k gSA.]}}}

8 (b) rejected for the reason . Rkkjh[k% Date: fuokZpd jftLV vkfQlj Electoral Registration Officer irk------------------------------------- ------------------------- Address .. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&&&&&. ikorh@jlhn Acknowledgement/Receipt ikorh la- &&&&&&&&&&&&&& rkjh[k &&&&&&&&&&&&&&. Acknowledgement Number _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date __ _ _ _ _ _ _ _ _ _ _ _ _. Jh@Jherh@dqekjh &&&&&&&&&&&& &&&&&&&&&&&&&&&&&&&&&& dk iz:i 8 esa vkosnu izkIr gqvk gS. [vkosnd vkosnu dh fLFkfr tkapus ds fy, ikorh la- fufnZ"V dj ldrk gS]. Received the application in form 8 of Shri / Smt.]]

9 / Ms. _____. [Applicant can refer the Acknowledgement No. to check the status of application]. bZvkjvks@,bZvkjvks@ch,yvks dk uke@gLrk{kj Name/Signature of ERO/AERO/BLO. nwjHkk"k ua0 mRrjdk'kh& peksyh kx& fVgjh x<+oky& nsgjknwu& gfj}kj-& ikSM+h&x<+oky 01374&222177 01372&252139 01364&233352 01376&232164 0135-2624216 01334-239942 01368&222217. yS0 01374&1950 01372&1950 01364&1950 01376&1950 0135&1950 01334-1950 01368&1950. ykbZu@ fiFkkSjkx<+ ckxs'oj vYeksM+k pEikor uSuhrky m/keflaguxj Vksy Qzh& 05964&225236 05963&220380 05962&230010 05965&230296 05942&235284 05944&246787. 05964&1950 05963&1950 05962&1950 05965&1950 05942&1950 05944&1950. iz:Ik&8 ds lkFk layXu gksxk To be appended to Form-8.

10 Vkosnu iz:i&8 Hkjus ds fy, fn'kk&funsZ'k GUIDELINES FOR FLLING UP THE APPLICATION. iz:i&8 FORM-8. iz:i&8 dSls Hkjk tkuk pkfg, How to Fill up Form-8. 1- vkosnu ml fuokZpu &{ks= ds fuokZpd jftLV vf/kdkjh dks lacksf/kr fd;k tkuk pkfg, ftlesa vkosnd dk uke igys ls gh varosZf'kr gSA fuokZpu {ks= ds uke dk fjDr LFkku esa mYys[k fd;k tkuk pkfg,A. 1. The application should be addressed to the Electoral Registration Officer of the constituency in which the name of the applicant is already included. The name of the constituency should be mentioned in the blank space. 2- vkosnd dks vkosnu ds Hkkx I en d vkSj [k esa viuk uke ml :Ik esa fy[kuk pkfg, tSlk fd mls fuokZpd ukekoyh esa izrhr gksA.]]]}}