FORM-6
G eros a ra ese al 0) cipro 7
GY
ELECTION COMMISSION OF INDIA (Totes tes
Application Form for New Voters
%
‘The Eecualegraton fe,
‘No. & Name of Assembly Consttuency No, uF ‘Name: Pariah
(4 Ne anette Ws ta
|(GOni for Union Tertones not having Legislative Asse) el
‘aspect grat ttre coe
(1a) Namen Pte Language of Stat)
Fane load MEN TT
Sonne)
(0) None ngs ace LTRS
ane load Me Rane OAR ¥
Sorave(¢ a PAL
Dechne renet en lee yt
(Qa) Name and Suame (n oficial language of State) of ay one ofthe rates:
fate | J Or Mather Or Hesband [] Or te or
L 4
eps Guo nee ome
2i(d} Name and Sumsame (1 Engi in BLOCK LETTERS) of therelatve mentioned above YASH PIAL
m8
(eben set oan 7 ‘ToT Ts
J
fede reteneat tena 2 ee l
(omar sere) shrapaasogntson
®
tate mentnedat aN 2
(9st Oi TL LT
(6) G2r0er wae IT FEMALE “THRO GENDER [
Meat
; ai ol
(ta etet rm rm aI Lc
(t) Sel test oy of oooen sparing ae pox tae (anyone tte fowrg)
(Decument:Faf fDatct Bh ny oct)
1 hee Compe alec ue ress
7) batences a) antes 1) tito isew
1) ceniicsts of cas XarCss Missed by CBSENCSE, Stee EdvemonBoas cota Date of rh 6f] IndanPasspot
(i day er Dc et Dae of eth to daca ie bl) PL Sec(Peer ray eséee Fl Ate)
Yossiuisrsiperthe Wan fexrenee Skrpine Aasiewsicaes gReT | Sieikeocy hal tghe scr tS TTAB IS
een poe Towle Mara mana BE Tet
Posie Maga BAR Scoot Mowat
istic Ried Frode aa
(te tet ny of tes poster enact plato anne ofpaenscutela cl fate enoledasaecurat te sane acess (acnanjone of)
(9 Dscumen to ratte
1 onBeey coment oes
2) tates 37) Corer hex er | rawr
5) Reeve ener Lng Oming corsage 6 Reged Ren ese ednset en)
7) ensue renee eins
(i day ter Donat Po tence fe dcumet rat. 3.
(ena iy ty Opn) osama Yeu Det Dunb
any (Secs
Posteo sbi Pcetcate tached tessa bu) Yes! | No
(10Te ta fmy an mroe ea nowet heat ature ase wth nto cre ele ae at unr
aneotfeniy mb: ASH PAL Festosp wines Fate she Foro,
ecLagaTiON.
"HERE OECLARE ato te eto my ewe ane
(am ache nando iti Twn ape mab
Diet Rage Ste aah
(ila nat recientes menned Ne.) norm 6 once: 200-07
(in am apg rnc iE ol rte st ied my are cated any sey Center atime Conte.
(i et poses an ote dcumetsf ge pl. Tho, hareecoe: Mane! he decume supa age el (Stk int ple)
(amare tanking above sare declan eto his platonic sea which in bee eal octet espe ancr Sein 3 of Represent
‘te People ct 180 (8 of 550] timp aterm wich may tert ne ear eit fie wth beth.
ate 2boraes
Lace MBA
‘scesityetctons nh pt tps of Rpts Persons whales At 206 and igh Pao wih Debts ues, 2017 nese pasos wh nla esl atm cbr pay ad
at tits, strc hand hunt ipso of paso wih atc Sis ole hand hu ingress ap gran ib ee
te
[nese ofa mare mae apn ane fd perl be mene
* | Sibson atest copy una lamar spy ero aie.
7 |i none oth doses ab, ol rein mus seep aegay hanes Sins we ae ewe wg Bene dc idol poses any dxunaay poof
cay ce, acter Rial cr shal esl nice el vetaton
comneemecat
Asreegene urbe S13TEOAN2OT2E20167 are zeotee
em
poleteenFeen ot shvSau Ms dry pd ET
Vesa can eft Aaowdgenst a chk satus tpl]
‘This isa computer genre ceeurnt and cet ot req sinate ™