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chown unbe-stzz90neO 2000 ‘domssonDt:-08102008 FORMS g (See Rules 153) and (2) ofthe Registtion of Electors ono Q Puls, 1960) 4 Y ELECTION COMMISSION OF INDIA fetes ‘Voter Application Form for Shifting of Residence/Correction of Entries in Existing Electoral Roll / Replacement of EPIC | Marking of PwD 7 ‘Te hetual agtaen fo, anon ove Cote Me ene NEIGH (re. ae Panera airy me ane. (g nyo Teens oa egsie eed) (inanectespplert- RAESHRIMAR PON owsisue Jahr iis: Paice cei [vst LI ® amt co fuihy aa Nunber becuse drthare cho Maer obo. eto oto. Fatecte tye eae Feil) T Enalic(0) alc Fates bea aaa) (0 Isuktappictontr (icky teflon) 1 Singles) 2 cancion ot sin ig Eira (x) sweet eaenet PC wat cocoa) 4 eyes rmatingesPexowibDisbily | toon Siting of esiece tae i mys ret aya abe ld a te pests an hited ecard est sepa PC ay lsd me ea agen als | babyy ERC. rset Orray | Hace Budnggeret ] ‘Steely haat eee Fes Aides) EET Telstar Dit ] Seal Saas yo ates poate nthenaneot pleat anore ct hepato ut cl ae eo hase atecane ass tah ay ont He oct meebo} 1 Vise hy as Barat aes ales ye) 1 Ashe Ca a caer passbook arash BaP oe 4 nidanrasoet 5 Ree DepernetsLind Owning ecards gina ‘ ese et Lene eed nasal > ajuda owns) dye Pps, 2. doesn Conti ot isi iting Seer Ro eae erect yong alsin Beta LEPC: inal ep crecoc (Puta v dnbspin appropri bor belon) copyattetarerts rumen Boon apperatla te enshat Spice soRPASTNG NE ) ] Fee ASOR we tee 2 sate 3s [oan wreak 2 pelt ‘ Pee 6) atte sora escunas [ uatennoe + [ne casera — — FPL cE sono (oWv Fr ‘Tracorciptiar inthe ryt cnsciedareso unde AERO (HY FOTO rpazena) | ven amet aggrecan ae | a 2 | a t eas innate pra iy tra {pain fr Keo ie Pw Gan squats eres ran snatoseemygro aeteinegpteta) + Jue 2 [2] soeantonentestalisin eters 7) i | ery retum myrtle ld EPIC (OR) have tached copy of FR/Polie report for lost EPIC & | undertake to retun the earier EPIC issued to mei the same is recovered at alate stage. 4 topic for Marking Person with Disabity apy any teeta Leone Yoal batons Iayite Odeo) Pest O cote oe tespt) Jw Ce canon 1 HEEEYOECLARE at to he Bs fy Kowa ell that 1am ale fa ant | a star at ing a tenet cet wih se sd wich | Ko Bee be fae 1 i olve obete,punhle nr Seen 7 apesnatn of he People Act10 (4 of 150) wih impitenmenfr atm ich ay etd f oe yr or wth i with oth Decode ess seni hops tho Pers wastes et 20 6a ats cf Peron Dees les 07 nest ofp teal sy vm cetyl diese, spatrer had fun inpessin peso dsl of it oe ad tunbnpessoncf tise garde eed "Sibi te esd oy of ened name es pendy deeyfrne x OK OK “eeldgeneri Rectan «KK eorkignen nb -SamOmaNED IND ae abst ‘era te latino SMS RARESHRUMAR anise ROHEROBLO THe conta gat acme and dos net qu ae =

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