"FORM 7"
[See rules 13(2) and 26]

 Application for objecting inclusion or seeking deletion of name in electoral roll

To
The Electoral Registration Offer,

Assembly/ Parliament£ Constituency

Sir,
          @I object to proposed inclusion of the name of the undermentioned person in the electoral roll for the above Constituency. Particulars in my objection are given below:
or
      @I submit that the entry related to *myself / the person named below is required to be deleted for the reasons stated hereunder:
I. @Details of person inclusion of whose name is objected to:
  @Details of person whose entry is to be deleted:		 Name
  Surname (if any)
   
Part number of electoral roll in which his/her name is included: His/her serial number in that part: Electors' Photo Identity Card (if issued) Number: 
*II
 Details of objector
 Name Surname (if any)
   
Sex:
  		Part numebr of electoral roll in which Objector's name is included: His serial number in that part:   

*Father's

Mother's Name

Husband's

Name Surname (if any)
   
III. Particulars of place of ordinary residence of @objector/ @person seeking deletion. (Full address)
House / Door number:               
Street / Area / Locality/ Mohalla /Road:   
Town / Village                 
Post Office:                              Pin Code
Tehsil / Taluka / Mandal/ Thana          
District:                                 

£In case of Union Territories having no Legislative Assembly and the state of Jammu and Kashmir.
@ First alternative will be relevant during preparation/ revision of electoral roll. Second alternative will be relevent during continuous updating after final publication of electoral roll. Strike out the inappropriate alternative.
* Strike out the inappropriate alternative.
#part-II not to be filled where applicant seeks deletion of entry relating to himself.

....................................................................(Perforation)......................................................................
 
Receipt for application

Recevied the application in Form 8 of **Shri / Shrimati / Kumari
**Address

Date                                               Signature of the officer receiving the application on                                                                                   behalf of the Electoral Registration Officer                                                                                             (Address)
**To be filled by the applicant.

IV. Reason(s) for *objection/*deletion:
V. Declaration
I hereby declare that the fact and particulars mentioned above are true to the best of my knowledge and belief.

Place:      Date:         Signature of thumb impression of the applicant

Note- Any person who makes a statement of declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under section 31 or the Representation of the People Act, 1950 (43 of 1950).

* Strike out the inappropriate alternative.

Details of action taken
(To be filled by Electoral Registration Officer of the Constituency

The application of Shri/Smt./Km
*Objecting to inclusion seeking deletion of name of Shri/Smt./Km. in the electrol roll in Form 7 has been accepted* / rejected*.

Detailed reasons for * acceptance [under or in pursuance of rule 18*/20*/ 26(4)]£ or *rejection [under or in pursuance of rule 17*/20*/26(4)£];


Place:                                                 
Date                        Signature of                                        (Seal of the Electoral
                                   Electoral Registration Officer                                Registration Officer)

£During continuous updating after final publication of electoral roll.
* Strike out the inappropriate alternative.