FORM 8A (SEE rule 26) Application for transposition of entry in electoral roll To The Electoral Registration Officer, ....... Assembly/e Parliamentary Constituency. Sir, I request that the entry in the electoral roll for the above mentioned Constituency relating to *Myself/*person named below should be transposed to the relevant part of the roll in this Constituency. Particulars of the entry to be transposed are given below: I. Details of person whose entry is to be transposed 1. Title $ 2. First and middle name 3. Last name 4. Part number of electoral roll in which his/her name is included: 5. His/her serial number in that part: 6. Electors Photo identity Card Number II. (a) Details of relation of person whose entry is to be transposed (Father/mother/ husband) 7. Title $ 8. First and middle name 9. Last name (b) Relationship with the person whose entry is to be transposed. Father/Mother/Husband: III. Full new address (changed place of residence of the person whose entry is to be transposed) 10. House/ Door number: 11. Street/Mohalla/Road/Gali: 12. Area/ Locality: 13. Town/Village: 14. Post Office: 15. Pin Code: 16. Police Station: 17. Tehsil/Taluka @: 18. Block/Mandal (for Village)@: 19. District: IV. Period of continuous residence at the above address on the date of application 20. Years 21. Months: V. Details of Local Body and Ward in which the new place of Ordinary residence at III above is included 22. a) Notified Area Committee/ Municipality/ Municipal Corporation/ Cantonment Board (for urban area) etc.: Or b) Gram Panchayat (for rural area): 23. Ward number of the above Local Body: * Strike out the inappropriate alternative $ Sh./Smt/Km./Dr. etc. @ May not be applicable in Metropolitan Areas e In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir VI. Part number to which the entry has to be transposed (if known): VII. # Details of applicant 24. Title $ 25. First and middle name 26. Last name 27. Part number of electoral roll in which his/her name is included: 28. His/her serial number in that part: 29. Electors Photo Identity Card number VIII. # (a)Details of relation of applicant (Father/Mother/ Husband) 30. Title $ 31. First and middle name 32. Last name (b) Relationship with applicant. Father/Mother/Husband: IX. # Particulars of place of ordinary residence (Full address): 33. House/ Door number: 34. Street/Mohalla/Road/Gali: 35. Area/ Locality: 36. Town/Village: 37. Pin Code : 38. Post Office: 39. Police Station: 40. Tehsil/Taluka : 41. Block/Mandal (for Village): 42. District: X. Declaration I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge and belief. Place: Date: Signature or thumb impression of applicant I am submitting the application to the Electoral Registration Officer through (i) Sh./Smt./ Km. (full name and address) or (ii) in person, / or (iii) by Post ................... Signature or thumb impression of applicant Note-Any person who makes a statement or declaration which is false and which he either knows or believes to be false or does not believe to be true, is punishable under section31 of the Representation of the People Act, 1950. $ Sh./Smt./Km./Dr. etc. # Pats VII. VIII & IX not to be filled where applicant seeks transposition of his own entry. This is only to be filled when an application for transposition is made in respect of someone else who is an Elector. * Strike out the inappropriate alternative. Signature or thumb impression of the Person submitting the application. For use of registration officer or other officer designated by him Details of acknowledgement (To be filled by Officer receiving the application) Details of acknowledgement receipt issued to the applicant. Receipt number: Signature of officer receiving the application Date of receipt: Remarks, if any, of the Officer receiving the application: Application received by: Name of Officer: Designation *: Place: Date: Signature of Officer receiving the application * Electoral Registration Officer/ Assistant Electoral Registration Officer Details of action taken (To be filled by electoral registration officer of the Constituency) Revision identity Constituency number and name The application of Shri/Smt./Km. ............. for transposition of entry relating to himself/herself/Shri/Smt./Km. ..................in the electoral roll in Form 8A has been accepted*/ rejected* * Accepted: Under rule 26(4) and relevant entry of electoral is transposed in the electoral roll of the Constituency. Before transposition After transposition Serial number Part number Serial number allotted In part number * Rejected: Rejected, under rule 26(4) * Detailed reason for acceptance or rejection [under rule 26(4)]*: Place: Date: Signature of Electoral Registration Officer * Strike out the inappropriate alternative.
