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Application for inclusion of name in electoral roll ApplicationID:11113679
To,
The Electoral Registration Officer
*Assembly Constituency: Yellandu (ST)
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: SHARATH CHANDRA .a:
Surname(if any): TATAVARTY .a: o
Date of birth if you know: Day:06 Month:07 Year:1993 Gender: M
Age as on 1st January 2013: Year:19 Months:5
Place of birth Place of birth
Village/ Town: BELLAMPALLY
District: ADILABAD State: ANDHRA PRADESH
Relation Details
Relation Type
Father's/Mother's/Husband's:
F
Name: MURALI KRISHNA MOHAN RAO .a: :0 ' oy
Surname(if any): TATAVARTY .a: o
II. Particulars of place of present ordinary Residence(Full address)
House/Door number: C2-17
Street /Area /Locality
/Mohalla /Road:
J K COLONY Dc o's0: _ s
Town/ Village: YELLANDU n : :
Tehsil/ Taluka/Mandal/
Thana:
YELLANDU c : :
District: KHAMMAM Post Office: YELLANDU
Pin code: 507123
III. Details of member(s) of applicant's family already included in the current electoral roll of the Constitutency:
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III. Details of member(s) of applicant's family already included in the current electoral roll of the Constitutency:
Name:
Relationship with
applicant:
RPart number of the
roll of the
Constitutency:
Serial number in the
Part:
Elector's Photo Identity Card
Number:
1. 0 0
2. 0 0
Mobile No: 0 Remarks:
Email-Id:
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