CHECK LIST OF GRADUATES VOTERS (FORM-18)

Sl.No Documents Enclosed (Yes/No)

1 Form-18 Application No.

2 Name

3 Photo

4 Epic Card

5 Aadhar Card

6 Residiential adress (……….)/Ordinary resident(………)……..…M/Y

7 Mobile No

Self Attestation of the applicant & duly authenticated by the Designated

8
officer/ Additional Designated Offiicer/Any other Gazetted Officer.

Copy of Qualification specified a graduates (Degree/Diploma) of a University

9
in the territory of Indiacolleges as per G.O M.s.NO.536, Dated : 28.09.2006.

Whether the applicant has studied minimum 15Yrs of study at School or

10
College Level .

Designated/Asst.Designated Officer

BLO SIGNATURE

The Person should ordinary resident in the constituency and passed degree before
Note :
31.10.2019***
 CHECK LIST OF TEACHERS VOTERS (FORM-19)

Sl.No Documents Enclosed (Yes/No)

1 Form-19 Application No.

2 Name

3 Photo

4 Epic Card

5 Aadhar Card

6 Residiential adress (……….)/Ordinary resident(………)……..…M/Y

7 Mobile No

Certificate for a total period of 3 yrs within the last preceeding 06 years
issued by the Head of the institution, in the presicribed format with Counter
8
Signed of 3 yrs working Certificate as per U.O
Note.No.1766214/MC/A1/2022, Dated :26.09.2022 issued from the CEO, AP.

Whether submitted the details of EPF/PF No. & deductions as per Memo
9
No.1187/Elecs.B/A2/2022-1, Dated :28.09.2022 issued by CEO,A.P

Whether it is checked the applicant is working in the List of Schools or

10 Educational inistutions coverd by as per G.O Ms.No 537 , 644 & 14 General
Admnistartion (Elecs) Dept.

Designated/Asst.Designated Officer

BLO Signature
The Person should ordinary resident in the constituency and working at least 3 yrs
Note :
service *** ( 01.11.2016 to 31.10.2022)