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Graduates Constituency Voters Enrollment Form 18
Graduates Constituency Voters Enrollment Form 18
(See Rule-31)
the
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4. **My name has not been included in the electoral roll for this or any
graduates constituency.
OR
**My
name
has
been
included
in
the
electoral
roll
for
the
5. I declare that I am a citizen of India and that all the particulars above are
true to the best of my knowledge.
Place: ______________________
--------------------------
Date: ______________________
Signature of Claimant
NOTE: Any person who makes a statement or declaration which is false and which the
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.
*Strike out the paragraph not applicable. **Strike off the inappropriate alternative.
Form designed by (Courtesy):
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ADDITIONAL INFORMATION
1. Name of the elector / applicant:
2. Fathers / Mothers / Husbands
name:
3.
(a) Whether registered as elector
for any assembly constituency:
(b) If Yes, then provide following
particulars
(i)
(ii)
(iii)
Date of Birth:
(iv)
(v)
Contact No.:
(vi)
YES / NO
Mobile:
Landline:
____________________________________
(Signature of the Elector / Applicant)
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address*
________________________________________________________________________
Date: _____________________
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application
in
Form
-18
of
Shri
Shrimati
__________________________________________________________,
Kumari
address
(a) Accepted
and
the
name
of
Shri
Shrimati
Kumari
for
the
reason
________________________________________________________________________
______________________________________________________________________
Date: _____________________
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