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The Electoral Registration Officer ATTINGAL Assembl Constituency
The Electoral Registration Officer ATTINGAL Assembl Constituency
The Electoral Registration Officer ATTINGAL Assembl Constituency
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FORM 6 [See rules 13(1) and 26] Application for inclusion of name in electoral roll Application No : S11128036002011000407 Hearing Date : 03.12.2011 To The Electoral Registration Officer ATTINGAL Assembl Constituency. 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: Name: Adeena A I. Applicant's details Name in Malayalam : Surname (if any) : Surname (Malayalam) :
Age as on 1st January : 2012 Date of birth, if known: Place of birth: Day: 25
Years: 18 Month: 05
Months: 7
Mother's Name
II. Particulars of place of present ordinar Residence (Full address) House No/ House Name: 769(279) / Al.adi.man il House No/ House Name (Malayalam): Street/ Area/Locality: Vali avila Kavunada Alamcode P.o Attingal Town/ Village/Panchayat/Municipality/Corporation: Karavaram Pancha at Post Office: Alamcode Tehsil/Taluk: Chira inkee hu District: THIRUVANANTHAPURAM III. Details of member(s) of applicant's famil alread included in the current electoral roll of the Constituenc : Name Najuma
# Please give the year i.e. 2007, 2008, etc. * Strike out the inappropriate alternative. www.ceo.kerala.gov.in/eregistration/eregistrationAppln.html?ApplnId=5418e
Pin Code:
695102
Relationship with Part number of the roll Serial number Elector's Photo Identity applicant of the Constituency in that Part Card Number Mother 36 966 KL/19/129/042245
In case of Union territories having no Legislative Assembly and the State of Jammu & Kashmir.
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