la[;k% 6&7@2011&bZ],y-,u-]
fnukad% f”keyk&171009]
9 ekpZ] 2011
**eq[; fuokZpu vf/kdkjh] fgekpy izns”k jkT; **
vf/klwpuk
9 ekpZ] 2011
fuokZpd jftLVªhdj.k fu;e] 1960 ds fu;e 8d ds v/khu
yksd izfrfuf/kRo ¼la”kks/ku½ vf/kfu;e] 2010] tks 10 Qjojh] 2011 ls
izo`r gqvk gS] }kjk yksd izfrfuf/kRo vf/kfu;e] 1950 esa vUr%LFkkfir /kkjk 20d ds v/khu izR;sd
izoklh fuokZpd vFkkZr~ Hkkjrh; ukxfjd] tks fu;kstu] f”k{kk ;k vU; dkj.kksa ls Hkkjr esa vius
lkekU; fuokl LFkku ls vuqifLFkr gS vkSj mlus fdlh vU; ns”k dh ukxfjdrk izkIr ugha dh gS
rFkk ftldk uke fuokZpd ukekoyh esa lfEefyr ¼ntZ½ ugha gS] ml fuokZpu {ks=] tgakW Hkkjr esa
mudk fuokl LFkku vofLFkr gS] tSlk fd mlds ikliksVZ esa n”kkZ;k x;k gS] dh ernkrk lwph esa
viuk uke jftLVªhd`r ¼ntZ½ djokus dk gdnkj gSA
fuokZpd jftLVªhdj.k fu;e] 1960 ds fu;e 8d ds fuca/kuksa ds vuqlkj
izR;sd izoklh fuokZpd] ftldk Hkkjr esa fuokl LFkku fgekpy izns”k jkT; esa vofLFkr gS] ftlus
01&01&2011 dks vBkjg o’kZ dh vk;q iw.kZ dj yh gS rFkk og viuk uke ernkrk lwph esa
jftLVªhd`r ¼ntZ½ djokus dk bPNqd gS] dks ,rn~}kjk ml fuokZpu {ks=] ftlesa mldk fuokl LFkku
vofLFkr gS] tSlk ikliksVZ esa n”kkZ;k x;k gS] dh ernkrk lwph esa jftLVªhd`r ¼ntZ½ djus ds fy,
iz:i 6d esa nkok vkosnu izLrqr djus ds fy, vkeaf=r fd;k tkrk gSA vkosndksa ds fy,
fn”kk&funZs”kksa lfgr iz:i 6d uhps fn;k x;k gSA iz:i 6d esa nkok vkosnu lEc) fuokZpu {ks= ds
jftLVªhdj.k vf/kdkjh dks ;k rks O;fDrxr :i ls lh/ks izLrqr fd;k tk;sxk ;k ,sls jftLVªhdj.k
vf/kdkjh dks Mkd }kjk iz:i 6d rFkk fn”kk funZs”kksa esa ;Fkk of.kZr nLrkostksa lfgr Hkstk tk;sxkA
tc nkok vkosnu Mkd }kjk Hkstk tkrk gS] rks ;g ikliksVZ ds lqlaxr i`’Bksa dh QksVksizfr;ksa] tks
lEc) ns”k esa Hkkjrh; fe”ku ds l{ke izkf/kdkjh }kjk lE;d :i ls lR;kfir gksa] lfgr Hkstk tkuk
pkfg,A
fgekpy izns”k jkT; esa izR;sd vM+lB fuokZpu fo/kku lHkk {ks=ksa ds
jftLVªhdj.k vf/kdkfj;ksa ds irs osclkbV
“http://ceohimachal.nic.in”
ij ns[ks tk
ldrs gSa A
gLrk@0
eukst dqekj
eq[; fuokZpu vf/kdkjh]
fgekpy izns”kA
No: 6-7/2011-ELN,
Dated: Shimla-171009, the
9th March, 2011
Chief Electoral Officer, Himachal Pradesh State
Notification
9th March, 2011
Under Rule 8A of the Registration of Electors Rules, 1960.
Under Section-20A of the Representation of the People Act, 1950,
inserted vide Representation of the People (Amendment) Act, 2010, which has
come into effect w.e.f. 10th February, 2011, every overseas elector, i.e., Indian
citizen who is absenting from his place of ordinary residence in India owing to
employment, education or otherwise, and has not acquired citizenship of any
other country and who is not included in the electoral roll, is entitled to have
his/her name registered in the electoral roll of the constituency in which his/her
place of residence in India as mentioned in his/her passport is located.
In terms of rule 8A of the Registration of Electors Rules, 1960,
every overseas elector whose place of residence in India is located in the State
of Himachal Pradesh who has completed 18 years of age as on 01-01-2011, and
is desirous of registering his/her name in the electoral roll, is invited hereby to
submit claim application in Form-6A for registration in the electoral roll of the
constituency in which his/her place of residence as shown in the passport is
located. Form-6A alongwith guidelines for the applicants is given below. The
claim application in Form-6A may be either submitted in person directly to the
registration officer of the constituency concerned or sent to such registration
officer by post alongwith the documents mentioned in Form-6A and the
guidelines. When the claim application is sent by post, it should be accompanied
by photocopies of the relevant pages of the passport duly attested by the
competent official of the Indian mission in the country concerned.
Addresses of the registration officers of each of the 68 Assembly
constituencies in the State of Himachal Pradesh can be seen on the website
“http://ceohimachal.nic.in”.
Sd/Chief Electoral Officer,
Himachal Pradesh.
la[;k% 6&7@2011&bZ],y-,u-]
fnukad% f”keyk&171009]
22 ekpZ] 2011
**fgekpy izns”k ljdkj**
**fuokZpu foHkkx**
“kqf)&i=
fgekpy izns”k ds jkti=] fnukad 9 ekpZ] 2011 esa
izdkf”kr]
fgekpy
izns”k
ljdkj
ds
fuokZpu
foHkkx
dh
vf/klwpuk
la[;k%6&7@2011] fnukad 9 ekpZ] 2011 esa] & i`’B 9493] iafDr 21 esa] **lEc)
ns”k esa Hkkjrh; fe”ku ds l{ke izkf/kdkjh }kjk lE;d~ :i ls lR;kfir ** ds LFkku
ij **lE;d~ :i ls Lor% vuqizekf.kr ** i<+sa A
gLrk@&
eukst dqekj
eq[; fuokZpu vf/kdkjh]
fgekpy izns”kA
No: 6-7/2011-ELN,
Dated: Shimla-171009,
the
22nd March, 2011
“Government of Himachal Pradesh”
“Election Department”
CORRIGENDA
In the Notification of Election Department, Govt. of
Himachal Pradesh No.6-7/2011-ELN, dated 9th March, 2011 published in the
Gazette of Himachal Pradesh, dated 9th February, 2011, - at page 9494, in
line 21-22, for “duly attested by the competent official of the Indian
mission in the country concerned” read “ duly self-attested”.
Sd/Manoj Kumar
Chief Electoral Officer,
Himachal Pradesh.
ßiz:i 6d
¼fu;e 8[k ns[ksa ½
fdlh izoklh fuokZpd }kjk fuokZpd ukekoyh esa uke lfEefyr fd;s tkus ds fy, vkossnu
lsok essa
fuokZpd jftLVªhdj.k vkfQlj]
------------------------- lHkk@lalnh; fuokZpu {ks=
------------------------------------ftyk
------------------------------------Hkkjr dk jkT;
bl [kkus ds Hkhrj
iw.kZ eq[k dks nf”kZr
djus okyk ¼3-5x3-5
ls-eh-½ dk gky gh esa
[khapk x;k ikliksVZ
vkdkj dk QksVks
fpidkus ds fy,
LFkku
egksn;]
eSa izkFkZuk djrk gwa fd mDr fuokZpu&{ks= ds fy,] ftlesa uhps en 1¼t½ esa izLrqr
fof”kf’V;ksa ds vuqlkj esjk fuokl LFkku vofLFkr gS] fuokZpd ukekoyh esa esjk uke lfEefyr dj fy;k tk, A
Hkkx&d
fuokZpd ukekoyh esa lfEefyr fd;s tkus ds fy, esjs nkos ds leFkZu esa fof”kf’V;ka uhps nh xbZ gaS %
¼d½
¼[k½
¼x½
¼?k½
¼³½
¼p½
¼N½
¼t½
uke &&&&&&&&&&&
e/; uke&&&&&&&&&
mi uke&&&&&&&&&
tUe dh rkjh[k &&&&fnu&&&&&ekl&&&&&o’kZ
fyax ¼iq:’k @ L=h½
tUe dk LFkku&&&&&&&&&
(i) xzke@uxj&&&&&&&&&
(ii) ftyk&&&&&&&&&&
(iii) jkT; &&&&&&&&&&
firk@ekrk@ ifr dk C;kSjk
(i)
uke &&&&&&&&&&&
(ii) e/; uke&&&&&&&&&
(iii) mi uke&&&&&&&&&
Hkkjr esa ekewyh rkSj ij fuokl dk LFkku ¼ikliksVZ esa fn, x, vuqlkj iwjk irk½
(i)
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
edku @ x`g la[;k &&&&&&&&&&&&&
xyh @{ks=@ifj{ks=@eksgYyk@lM+d &&&&&&&&&&&
uxj @ xzke&&&&&&&&&&&&&&
Mkd?kj&&&&&&&&&&&&
fiu dksM &&&&&&&&&&&&
rglhy @rkyqd @ eaMy@ Fkkuk&&&&&&&&&&&
ftyk &&&&&&&&&&&&&&
¼>½ ikliksVZ dk C;kSjk
(i)
ikliksVZ la[;k &&&&&&&&&&&&&&&
(ii) orZeku Hkkjrh; ikliksVZ ds tkjh gksus dk LFkku &&&&&&&&&&&&
(iii) orZeku Hkkjrh; ikliksVZ ds tkjh gksus dh rkjh[k &&&&&&&&&&&&
(iv) orZeku Hkkjrh; ikliksVZ ds volku dh rkjh[k &&&&&&&&&&&&&
¿ Åij en ¼d½ ls ¼>½ esa of.kZr fof”kf’V;ksa dks varfoZ’V djus okys ikliksVZ ds lqlaxr i`’Bksa dh&;fn Mkd }kjk
Hkstk tkrk gS rks lE;d~ :i ls Lor% vuqizekf.kr izfr;ksa dks vkSj ;fn O;fDrxr :i ls jftLVªhdj.k vkfQlj ds
le{k izLrqr fd;k tkrk gS rks izfr;ksa ds lkFk ewy ikliksVZ ds lkFk layXu djsaA À
¼¥½ orZeku fuokl ds ns”k ds ohtk dk C;kSjk &
(i)
ohtk la[;k &&&&&&&&&&&&&&&
(ii)
ohtk dk izdkj ¼,dy izos”k@cgqfo/k izos”k@i;ZVd@dk;Z ohtk vkfn½&&&&&&&&&&&
(iii)
ohtk ds tkjh gksus dh rkjh[k &&&&&&&&&&&&
(iv)
ohtk ds tkjh gksus dk LFkku &&&&&&&&&&&&
(v)
ohtk ds volku dh rkjh[k &&&&&&&&&&&&
(vi)
tkjh drkZ izkf/kdkjh dk uke&&&&&&&&&&&&&
¿ Åij mfYyf[kr orZeku fof/kekU; ohtk i`’Bkadu dks vUrfoZ’V djus okys ikliksVZ ds lqlaxr i`’Bksa dh&;fn
Mkd }kjk Hkstk tkrk gS rks lE;d~ :i ls Lor% vuqizekf.kr izfr;ksa dks vkSj ;fn O;fDrxr :i ls jftLVªhdj.k
vkfQlj ds le{k izLrqr fd;k tkrk gS rks izfr;ksa ds lkFk ewy ikliksVZ ds lkFk layXu djsaA À
2-
Hkkjr esa ekewyh rkSj ls fuokl ds LFkku ls vuqifLFkfr dk o.kZu &&&&&&&&&&&&&&&&&&&&&&
¼d½
Hkkjr esa ekewyh rkSj ij fuokl ds LFkku ls vuqifLFkr gksus dk dkj.k& (i) fu;kstu @ (ii) f”k{kk@
(iii) vU; ¼ fooj.k nsa ½
¼[k½
3-
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
og rkjh[k ftlls Hkkjr esa ekewyh rkSj ij fuokl ls vuqifLFkr jgk gS A
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&¼fnu@ekl@o’kZ½
Hkkjr ls ckgj ds ns”k dk iw.kZ vkoklh; irk] tgka og orZeku esa fuokl dj jgk gS &&&&&&&&&&&&
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&A
4-
Hkkjr ls ckgj ds ns”k dk iw.kZ “kkldh; irk tgka og orZeku esa fuokl dj jgk gS ¼fu;kstu ;k
“kS{kf.kd laLFkk] tgka og v/;;u dj jgk gS] ds LFkku dk irk½&&&&&&&&&&&&&&&&&&&&&&&&
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&A
5-
?kks’k.kk & eSa ?kks’k.kk djrk gwa fd esjs lokZsÙke Kku vkSj fo”okl ds vuqlkj&
¼d½ bl vkosnu esa nh xbZ lEiw.kZ tkudkjh lR; gS A
¼[k½ eSa tUe ls@vf/kokl ls@ns”kh;dj.k }kjk Hkkjr dk ukxfjd gwaA
¼x½ eSaus fdlh vU; ns”k dh ukxfjdrk vftZr ugha dh gS A
¼?k½ fdUrq Åij 2d esa fn, x, dkj.k ls Hkkjr esa esjs ekewyh fuokl ds LFkku ls vuqifLFkr gksus ds
dkj.k] eSa esjs Hkkjrh; ikliksVZ esa fn, x, irs ij ekewyh rkSj ij fuoklh jgwaxk] ftls Åij 1¼t½
esa mn~/k`r fd;k x;k gS A
¼³½ eSa esjs }kjk Hkkjrh; ukxfjdrk dk R;kx fd;s tkus ;k esjs }kjk fdlh vU; ns”k dh ukxfjdrk
vftZr fd, tkus ij esjs orZeku fuokl ds ns”k esa Hkkjrh; fe”ku ds ek/;e ls fuokZpd
jftLVªhdj.k vkfQlj dks rRdky lwfpr djus dk opu nsrk gwaA
¼p½ esjs fuokl ds ns”k esa esjs fuokl ds irs esa dksbZ ifjorZu gksus ij fuokZpd jftLVªhdj.k vkfQlj ds
vfHkys[k ds fy, eSa esjs orZeku fuokl ds ns”k esa Hkkjrh; fe”ku ds ek/;e ls fuokZpd jftLVªhdj.k
vkfQlj dks rRdky lwfpr djus dk opu nsrk gwaA eSa ;g tkurk gwa fd esjs fuokl ij Hkstk x;k
dksbZ uksfVl] tks fd fuokZpd jftLVªhdj.k vkfQlj ds vfHkys[k ds vuqlkj esjs orZeku fuokl ds
ns”k esa esjs fuokl dk irk gS] yksd izfrfuf/kRo vf/kfu;e] 1950 vkSj mlds v/khu cuk, x, fu;eksa
ds v/khu eq>s uksfVl dh lE;d~ rkehy le>h tk;sxh] vkSj ;g esjk mÙkjnkf;Ro gS fd esjs orZeku
fuokl ds ns”k esa esjs v|ru fuokl ds irs dh lwpuk eSa fuokZpd jftLVªhdj.k vkfQlj dks
nsrk jgaw A
¼N½ ;fn eSa Hkkjr okil ykSVrk gaw vkSj Hkkjr esa ekewyh rkSj ij fuoklh gks tkrk gwa] rks eSa lacaf/kr fo/kku
lHkk@lalnh; fuokZpu&{ks= ds fuokZpd jftLVªhdj.k vkfQlj dks rRdky lwfpr d:axk A
¼t½
eSaus fdlh vU; fuokZpu&{ks= dh fuokZpd ukekoyh esa esjk uke lfEefyr fd, tkus ds fy, vkosnu
ugha fd;k gSA
¼>½
bl ;k fdlh vU; fuokZpu&{ks= esa esjk uke igys lfEefyr ugha fd;k x;k gS A
;k
esjk uke &&&&&&&&&&&&&& jkT; ds &&&&&&&&&&&& fuokZpu&{ks= ds] ftlesa eSa uhps
mfYyf[kr irs ij igys ls gh ekewyh rkSj ls fuokl dj jgk Fkk] fuokZpd ukekoyh esa lfEefyr
fd;k tk ldsxk vkSj ;fn ,slk gS rks eSa izkFkZuk djrk gwa fd mls ml fuokZpd ukekoyh ls gVk
fn;k tk, ;k LFkkukarfjr dj fn;k tk,] tSlk Hkh mi;qDr gks A
iwjk irk ¼ekewyh rkSj ls fuokl dk iwoZ LFkku½ &&&&&&&&&&&&&&&&&&&&&&&&&&&
fuokZpd QksVks igpku i= la[;kad ¼;fn tkjh fd;k x;k gS ½ &&&&&&&&&&&&&&&&&&
tkjh djus dh rkjh[k &&&&&&&&&&&&&&&&&&&&&&&&&
¼´½
eq>s Hkkjr esa fuokZpd QksVks igpku i= tkjh ugha fd;k x;k gS@fuokZpd QksVks igpku i= tkjh
fd;k x;k gS tks fujLrhdj.k ds fy, bl vkosnu ds lkFk layXu gS A
gLrk{kj &&&&&&&&&&&&&
LFkku &&&&&&&&&&&&&&
Rkkjh[k &&&&&&&&&&&&&&
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Hkkx&[k
¼ fuokZpd jftLVªhdj.k vkfQlj ds dk;kZy; esa iz;ksx ds fy, ½
&&&&&&&&&&&&&&&&&&&¼ fnu@ekl@o’kZ ½ dks vkosnu izkIr gqvk
Jh @Jherh@ dqekjh&&&&&&&&&&&&&&&&&& dk iz:i 6d esa vkosnu %&
¼d½ Lohdkj dj fy;k x;k gS vkSj mlds uke dks &&&&&&&&&&&&&& ¼fuokZpu {ks=½ dh fuokZpd ukekoyh
ds Hkkx la- &&&&&&&& esa Øe la- &&&&&&&&&&& ij lfEefyr dj fy;k A
¼[k½ ukeatwj djus ds foLr`r dkj.k &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
Rkkjh[k&&&&&&&&&&&&&
[ fuokZpd jftLVªhdj.k vkfQlj ]
&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&
----------------------------------------------------------------------------------------fNnz.k-----------------------------------------------------------------------------------------------------------------------
Hkkx&x
vkosnu dh vfHkLohd`fr
¼ tc O;fDrxr :i ls jftLVªhdj.k vkfQlj dks izLrqr fd;k tk, ½
iz:i 6d esa Jh @Jherh@dqekjh &&&&&&&&&&&&&&&&&&irk &&&&&&&&&&&&&&&&&&&&&&& dk
vkosnu izkIr gqvk A
rkjh[k&&&&&&&&&
lR;kiu djus okys vf/kdkjh ds gLrk{kj&&&&&&&&&&&&&&&&&&
irk &&&&&&&&&&&&&&&&&&&&&&&&&&&&&ÞA
iz:i 6d esa vkosnu Hkjs tkus ds fy, ekxZn”kZd fl)kUr
lk/kkj.k vuqns”k
iz:i 6d fdlds }kjk Hkjk tk ldrk gS
1fons”k esa jgus okyk Hkkjr dk izR;sd ,slk ukxfjd] ftlus fdlh fons”k dh ukxfjdrk vftZr ugha dh gS
vkSj o’kZ dh 1 tuojh dks 18 o’kZ dh vk;q iwjh dj yh gS] ml voLFkku ls] ftlesa mlds ikliksVZ esa
;FkkmfYyf[kr Hkkjr esa mldk fuokl LFkku vofLFkr gS] lacaf/kr fuokZpu&{ks= dh ukekoyh esa jftLVªhdj.k ds
fy, iz:i 6d esa vkosnu dj ldrk gSA iz:i 6d esa vkosnu dks lacaf/kr jftLVªhdj.k vkfQlj ds le{k izLrqr
fd;k tk ldrk gSA
2vkosnd us o’kZ dh 1 tuojh] dks vBkjg o’kZ dh vk;q iwjh dj yh gksA mnkgj.kkFkZ] ;fn fuokZpd
ukekoyh esa uke dks lfEefyr djus ds fy, vkosnu 1&1&2011 dh vgZd rkjh[k ds izfrfunZs”k ls gSa] rks vkosnd
}kjk 1&1&2011 dks 18 o’kZ dh vk;q iwjh dj yh xbZ gks A
iz:i 6d esa vkosnu dks dgka izLrqr fd;k tk,
3vkosnu dks ml fuokZpu {ks= ds] ftlds Hkhrj fof/kekU; ikliksVZ esa fn, x, vuqlkj vkosnd ds ekewyh
fuokl dk LFkku vkrk gS] fuokZpd jftLVªhdj.k vkfQlj ¼bZvkjvks½ dks lh/ks izLrqr fd;k tkuk pkfg, A iz:i
6d esa vkosnu dks bZvkjvks dks O;fDrxr :i ls izLrqr fd;k tk ldrk gS ;k lacaf/kr bZvkjvks ds Mkd irs ij
Hkstk tk ldrk gS A
[ Hkkjr ds lHkh fuokZpu {ks=ksa ds bZvkjvks dh fof”kf’V;ka vkSj Mkd irs Hkkjr fuokZpu vk;ksx dh
osclkbV (http://eci.nic.in) ij ns[kh tk ldrh gSa ]
layXu fd;s tkus okys nLrkost
vkosnd ds iw.kZ eq[k dks nf”kZr djus okyk ,d gky gh esa [khapk x;k vkosnd dk ikliksVZ vkdkj dk
4,d jaxhu QksVks fpidk,a] ftldh i`’BHkwfe gYds jax ¼vf/kekur% lQsn½ dh gks A
5iz:i 6d ds lHkh lraHk Hkjsa A fof/kekU; Hkkjrh; ikliksVZ esa fn, x, vuqlkj viuk uke vkSj vU;
fof”kf’V;ka fy[ksa A
6;fn vkosnu Mkd }kjk Hkstk tkrk gS rks blds lkFk vkosnd ds QksVks vkSj vU; lHkh fof”kf’V;ka
vUrfoZ’V djus okys ikliksVZ ds lqlaxr i`’Bksa vkSj fof/kekU; ohtk i`’Bkadu vUrfoZ’V djus okys i`’B dh QksVks
izfr;ka layXu dh tkuh pkfg, A ;s QksVks izfr;ka lE;d~ :i ls Lor% vuqizekf.kr gksuh pkfg, A bu nLrkostksa dh
vuqizekf.kr QksVks izfr;ksa ds fcuk Hksts x, vkosnu lh/ks ukeatwj fd;s tkus ds nk;h gksaxs A
7;fn vkosnu dks O;fDrxr :i ls bZvkjvks ds le{k izLrqr fd;k tkrk gS rks vkosnu ds lkFk Åij
;FkkmfYyf[kr ikliksVZ ds lqlaxr i`’Bksa dh QksVks izfr;ka layXu dh tkuh pkfg, A jftLVªhdj.k vkfQlj }kjk
lR;kiu ds fy, vkosnu ds lkFk ewy ikliksVZ Hkh izLrqr fd;k tkuk pkfg, A lR;kiu ds rqjUr i”pkr~ ikliksVZ
dks ykSVk fn;k tk,xk A
ernku
8;g mYys[kuh; gS fd vki ds ukekadu ds i”pkr~~] vki fuokZpu {ks= esa ernku djus esa ml le; leFkZ
gksaxs] ;fn vki ernku ds fnol dks vius ewy ikliksVZ ds lkFk ernku dsUnz esa Lo;a mifLFkr gS A
“Form 6A
(see rule 8B)
Application for inclusion of name in the electoral roll by an overseas elector
To
The Electoral Registration Officer,
----------------------Assembly/Parliamentary
Constituency
District----------------State in India-----------------
Space for pasting
one recent passport
size photograph
(3.5x3.5 CM)
showing frontal
view of full face
within this box
Sir,
I request that my name be included in the electoral roll for the Constituency in
which my place of residence, as per the particulars furnished below in item 1(h), is located.
PART-A
Particulars in support of my claim for inclusion in the electoral roll are given below:(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
Name--------Middle Name-------Surname-----------Date of Birth-------Day--------Month------Year
Sex (Male/ Female)------------Place of Birth(i)
Village/ Town----------(ii) District--------------(iii) State-------------Father’s / Mother’s/ Husband’s detail
(i)
Name----------(ii)
Middle Name---------(iii) Surname---------Place of Ordinary Residence in India (Full Address as given in Passport)
(i)
House/ Door number---------(ii)
Street/ Area/Locality/Mohalla/Road-------(iii)
Town/ Village--------(iv)
Post Office----------(v)
Pin Code------------(vi)
Tehsil/Taluka /Mandal/ Thana--------(vii) District----------------Passport Details(i)
Passport number--------(ii)
Place of Issue of current Indian Passport----------(iii)
Date of Issue of Current Indian Passport----------(iv)
Date of expiry of Current Indian Passport-----------
{Copies of the relevant pages of the passport containing the particulars mentioned at items (a) to (i)
above to be enclosed –duly self -attested if sent by post and produced with the original passport if
presented in person before the registration officer}
(j)
Details of Visa of the Country of current residence(i)
Visa Number---------------(ii)
Type of Visa (Single Entry/ Multiple Entry/
Tourist/Work Visa etc.------------(iii) Date of Issue of Visa-------------------------(iv) Place of Issue of Visa-------------------------(v)
Date of expiry of Visa-------------------------(vi) Name of the Issuing Authority------------------
{Copies of the relevant pages of the passport containing the current valid visa endorsement mentioned
above to be enclosed-duly self-attested if sent by post and produced with the original passport if
presented in person before the registration officer}
2.
Description of Absence from Place of Ordinary Residence in India(a)
Reason of being absent from the place of ordinary residence in
India- (i) employment/ (ii) education / (iii) other (Give Description)
___________________________________________________
( b)
Date from which absenting from ordinary residence in India
_____________________________ (DD/MM/YYYY)
3.
Full residential address in the country outside India where currently
residing________________________________________________________
_______________________________________________________________
4.
Full Official address in the country outside India currently residing (address of the
place of employment or the education institution where studying)
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
5.
Declaration – I hereby declare that to the best of knowledge and belief(a) all information given in this application is true.
(b) I am a citizen of India by birth/domicile/naturalisation.
(c) I have not acquired citizenship of any other country.
(d) But for being absent from the place of my ordinary residence in India owing
to the reason given in 2(a) above, I would have been ordinarily resident at the
address given in my Indian Passport, which has been reproduced at 1(h) above.
(e)
I undertake to immediately inform the Electoral Registration Officer through
the Indian Mission in the Country of my current residence if I renounce my
Indian citizenship or if I acquire the citizenship of any other country.
(f)
I undertake to immediately inform the Electoral Registration Officer through the
Indian Mission in the Country of my current residence of any change in my
residential address in the country of my residence for the records of the Electoral
Registration Officer. I understand that any notice sent to me at the address, which is
my residential address in the country of my current residence according to the records
of the Electoral Registration Officer, shall be considered as due service of notice to
me under the Representation of the People Act, 1950 and rules made thereunder, and
that it is my responsibility to keep the Electoral Registration Officer informed of my
latest residential address in the country of my current residence.
(g)
If I return to India and become ordinarily resident in India, I shall immediately
inform the Electoral Registration Officer of the concerned Assembly/Parliamentary
Constituency.
(h)
I have not applied for inclusion of my name in the electoral roll of any other
constituency.
(i)
My name has not already been included in this or any other constituency.
Or
My name may have been included in the electoral roll of -------------------------------Constituency in ----------------------- State in which I was ordinarily resident earlier at
the address mentioned below and, if so, I request that the same may be deleted from
that electoral roll, or transposed, as may be appropriate.
Full address (Earlier place of ordinary residence) ---------------------------------------Elector Photo Identity Card (if issued) number ----------------------------------------Date of issue-----------------------------------------------------------------------------------
(j)
I have not been issued an EPIC in India/ have been issued an EPIC which is enclosed
with this application for cancellation.
Signature-----------------------Place--------------------------Date--------------------------_____________________________________________________________________________________
PART-B
(For use in the office of Electoral Registration Officer)
Application received ---------------------------- (DD/MM/YYYY)
The application in Form 6A of Shri/ Shrimati/ Kumari---------------------------------- has been:(a)
Accepted and the name has been registered in the electoral roll of ---------------------(Constituency) at Sr. No.----------------- Part No.--------------------------------------------
(b)
Rejected for the reason-------------------------------------------------------------------------
Date--------------[Electoral Registration Officer]
_____________________________________________________________________________
----------------------------------------------- perforation -----------------------------------------------------PART-C
Acknowledgement for Application
(When presented in person to the registration officer)
Received the application in Form 6A of
Shri /Shrimati /Kumari --------------------------------------------------------Address-------------------------------------------------------------------------Date---------------Signature of the Verifying Officer ___________________________
Address ____________________________”.
GUIDELINES FOR FILLING UP THE APPLICATION FORM-6A
General Instructions
Who can file Form-6A
1.
Every citizen of India staying in foreign country, who has not acquired citizenship of a foreign
country, and has completed 18 years of age as on 1st January of the year, can make an application in Form
6A for being registered in the roll for the constituency pertaining to the locality in which his place of
residence in India as mentioned in the passport is located. The application in Form 6A can be presented to
the registration officers concerned.
2.
The applicant should have completed eighteen years of age as on 1st January of the year. For
example, if the application is for inclusion of name in the electoral roll with reference to 01-01-2011 as
the qualifying date, the applicant should have completed 18 years of age as on 01-01-2011.
Where to submit the application in Form-6A
3.
The application should be submitted directly to the Electoral Registration Officer (ERO) of
the constituency within which the place of ordinary residence of the applicant as given in the valid
passport falls. The application in Form 6A can be presented in person to the ERO or sent by post
addressed to the ERO concerned.
[ The particulars and postal address of the EROs of all the constituencies of India can be
seen on the website of Election Commission of India (http://eci.nic.in)]
Documents to be attached
4.
Paste one recent passport size coloured photograph with a light background (preferably
white) showing the full face of the applicant.
5.
Fill in all the columns in Form 6A. Write your name and other particulars as given in
the valid Indian Passport.
6.
If application is sent by post, it should be accompanied by photo-copy of the relevant
pages of the passport containing the photograph and all other particulars of the applicant and the page
containing the valid visa endorsement. These photo-copies should be duly self-attested. Applications
without the attested photo-copies of these documents will be liable to be summarily rejected.
7.
If the application is submitted in person before the ERO, the application should be
accompanied by a photo-copy of the relevant pages of the passport as mentioned above. The original
passport should also be produced alongwith the application for verification by the registration officer. The
passport will be returned immediately after verification.
Voting
8.
It may be noted that after your enrolment, you will be able to cast vote in election in the
constituency, if you are physically present in the polling station alongwith your original passport on the
day of poll.