Application for inclusion of name in electoral roll ApplicationID:04633162

To,
The Electoral Registration Officer
*Assembly Constituency: Kukatpalle
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: SASIDHARREDDY . a:
co c
Surname(if any): THARIGOPULA . a:
con`y
Date of birth if you know: Day:26 Month:07 Year:1982 Gender: M
Age as on 1st January
2013:
Year:30 Months:5
Place of birth Place of birth
Village/ Town: BALANAGAR
District: RANGAREDDY State: AP
Relation Details
Relation Type
Father's/Mother's
/Husband's:
F
Name: TTHIMMAREDDY . a:
oc
Surname(if any): THARIGOPULA . a:
con`y
II. Particulars of place of present ordinary Residence(Full address)
House/Door number: 6-1-97
Street /Area /Locality
/Mohalla /Road:
NEAR HANUMAN TEMPLE Dc o 's0:
' `
Town/ Village: BALANAGAR n :

Tehsil/ Taluka/Mandal/
Thana:
BALANAGAR c :

District: RANGAREDDY Post Office: BALANAGAR
Pin code: 500042
III. Details of member(s) of applicant's family already included in the current electoral roll of the Constitutency:
FORM-6 http://ceoaperms.ap.gov.in/ERMS/Postal/userdetails.aspx
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