ELECTION COMMISSION OF PAKISTAN

FORM-21
[see rule 41(1)]
ENROLMENT / TRANSFER OF VOTE
UNDER SECTION 37 OF THE ELECTIONS ACT 2017
Form No:………………….
1. Name of electoral area ………………………….………… 2. Census block code

3. Application for: Enrolment of vote □ Transfer of vote □

4. Applicant’s name ……………………………….5. Father’s / husband’s name ……………………………….

6. Gender: Male □Female □ Eunuch (Male Eunuch □ Female Eunuch □ Khunsa-e-Mushkil □

7. National Identity Card No. - -

Day Month Year
8. Date of birth: -- --

9. Religion: Muslim□ Hindu□ Christian□ Sikh□ Buddhist□ Parsi □ Qadiani/Ahmadi □ Other non-Muslim □
Mark (√) in relevant column.

10. Particulars of address: House No……….. Street/mohallah………… City/town/village………………………………….

Name of patwar circle/tapedar circle…………………………………….. Union Council………………………………………

Tehsil/taluka……………………………………………District/Agency…………………………………………………………

Contact No. (Telephone/Mobile No.) …………….…………….…………….

11. Vote may be registered at: Temporary address as per NIC  Permanent address as per NIC  or

other address (In case applicant is in service of Pakistan) 

12. Only for persons in service of Pakistan:

Designation ………………… Department…………..Place of posting…………………………… (attach service certificate)

Relationship of the applicant with the person in service of Pakistan………………………………….……………………….

(In case of spouse and children of government servant, please attach service certificate of such government servant along with copy of National Identity Card)

13. I hereby state as follows:

(i) I am a citizen of Pakistan.
(ii) My age is not less than 18 years.
(iii) I have not been declared to be of unsound mind by a competent court.
(iv) I have not enrolled my name in the electoral roll of any other electoral area and if my name is already registered as
voter in any other electoral area in Pakistan that may be deleted.
Oath (only for Muslims): I do solemnly swear that I believe in the absolute and unqualified finality of the
Prophethood of Muhammad (Peace Be Upon Him), the last of the Prophets, and I am not follower of anyone
who claims to be a Prophet in any sense of the word or of any description, whatsoever after Muhammad (Peace
Be Upon Him), and that I do not recognize such a claimant to be a Prophet or a religious reformer, nor do I
belong to the Qadiani group or the Lahori group or call myself an Ahmadi.

Signature and thumb impression of the Applicant

Declaration: I do hereby declare and solemnly affirm that the particulars mentioned above are true to the best of my knowledge and
belief.
1. For transfer of vote only. My name is present in the electoral area: ………………………………………………………………

Census block code Tehsil/Taluka/town …..…………………….. District/Agency…………………..

at serial No. (on the electoral roll) …………….. and I want to transfer it to the above mentioned address.

Date of Form submission:

Day Month Year Applicant’s signature Applicant’s thumb impression
-- --

Note: Thumb impression is mandatory.

Note: Any person who makes a false declaration or gives information which he knows or believes to be false or does not believe to be true is liable to punishment under
sections 182 and 199 of the Pakistan Penal Code.
_______________________________________________________________________________________________________________________________________
*AUTHORIZATION
I hereby authorize Mr./Ms. ……………………………………… s/o, d/o, w/o …………………………………………

having National Identity Card No. - - to present this application on my

behalf.

Note: The authority can only be given to father, mother, spouse, son or daughter.
Signature of applicant Thumb impression of applicant Date
Day Month Year

Contact No…………………….
Signature of authorized person Thumb impression of authorized person

Relation with applicant……….

Contact No……………………
________________________________________________________________________________________________
To be filled in by the Registration Officer

Decision of the Registration officer:…………………………………………………………………………………………………….....

……………………………………………………………………………………………………………………………………………..

Brief reason(s) in case of rejection: :………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………….

Date ………………………………… Signature and stamp of Registration officer

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ELECTION COMMISSION OF PAKISTAN
RECEIPT
Application No………….

Name of electoral area …………………………………..…Census block code

Received application for registration / transfer of vote on Form (21) from Mr./Mrs./Miss……………………………..

son/wife/daughter of …………………………………………………………House No……………………………….

Street/Mohallah…………………………………………….City/town/village…………………………………….........

Tehsil/taluka/town…………………….……………………… District /Agency ………………………………………

Signature of Registration Officer

Date …………………………………