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‘cocueethmbe -SUUSSRCNA TANI ‘orssonDt-04-12.203 FORM 8 $ (See Rules 13(3) and (26 ofthe Reistraton of Electors Fon) __ 4 G: Ales, 1960) Y ELECTION COMMISSION OF INDIA mms Voter Application Form for Shifting of Residence/Correction of Entries in Existing Electoral Roll / Replacement of EPIC | Marking of PWD i “The BectoralRegistation Oct, ‘No and Name of Assembly Constituency Wo 5 Name Bangaon Uitar So serene, » ne na eee ep ASO (Wenecttespict- Tip da roho UES Asse 6a Paste pore) oJ sata hres oto Ts Ts Te Ts Ts [2 fs Ts Ts Lo J ® amos ater Narberth aaNet Meio otto el: iefe otie No ofFaeMnbeany aire ratio Set(0) Ea gore abe ti aD) (W Iswontaicaintr (ike efoto 1 sitattc Ha |] oretonot nes nensng cecal) 4 suet epee (2) mF fe fermatirg ss Pose otis [ “Aplin ting Rese ‘ese escece request amy ame abode re ees aes ant steno cre ages ered. pet et pBOeMET EPC te SL me ue RAEN ae | heey emmy oc RC Preset Orray [Hasenstein Sst Aea Lali loess escecehal = | Toioge oat Oe ces) PICO Tesi Taal Date sae Sefstaet cop ofatresspoct ete ntenaneotaxlcarta snore ofbesuertsoaseltlti tatexyenlesnthsseecrathesanesctess (Athan of hesbematsmetnalteb 1 eset Ges Bi that aes tes yr 2 ata 4) ccretasson ota Sheed ana Oe 4) inten Fesspot 5) ee ewe egztments zoning nas reg senda & fee rt Lest nasa 1 Paget ae Deen cae foro) cyte PS ‘Lipton Cnet ties sing Etre Pessocoret young iealsn@aea FAIR (Maia eerie beard) (Pca v sn cpp) Cun fetes oamatay Peat nsypat ota beatae, 1 7) tome 2 cet a Dobie 4 Fete 5 Pekin ae 6 ] sets 1 one a Tevoregatissnte ety oecrratel zeae ce Nave fDocmat hn spot tre caimatahes +___—— a a 6 J | eps tata ele Cray eis mec ocean pss et oan ny dapat fer sve o Reeser ERC wat caren lrepasteterienet Cyt ie oes ogra (Ptatcncrenrtton) 1 let 2 Desde ed an ease centres 4 Maat ‘ety etn mys] oc FOI coy of Ale poo st IC | neta eum theste EAD it omettesare Seoes te tgs “elicit tg sti Tee aparece oi) Locorabie sd vet aboro rayon Gece) Poceagct ay 8 Crs ati (Teta vs to DeLABITON | HEREBY DECLARE tt foe bs fy kweli at | ana en ot as I am ave tat mang = scant or Garton wih 6 ad whi | Kaw Beef be fe 0d ot leet be tis piste unde Sein 31 of Repent Ppl A 50 (6 of 15 with inpisnment fra tem wich may eed t ce ear ithe or th bt ie 0612.20 ce Gott Aves rons: psn gts Ps wn isi dt D6 nd gts ct Person wt Ds es 07m caecpesons whiner by ado ose pay ad mspe ibe, seer tat Fund npesn of peso sbi. of Sauer har huss cfihe rani “SUS etsy tend een Wl UES cae TC kk K ‘loaner apsetn KKK sreeret ante 508090022 ae: oes eset pian inom Bot SiS ls Tp Das NameSipae ct ONEFOBO Ti & compe gna dent a ues mt rere sate *™*

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