FORM 12-A [ See rule 20 (2) ] Application for Election Duty Certificate To The Returning Officer ............. Assembly Constituency. Sir, I intend to cast my vote in person at the ensuing election to the Legislative Assembly from the.................. Constituency. I have been posted on election duty within the Constituency but else where than the polling station at which I am entitled to vote. My name is entered at Serial No ................ in Part No. ......... of the electoral roll for ............. Assembly Constituency. I request that an Election Duty Certificate in Form 12-B may be issued to enable me to vote at the polling station where I may be on duty on the polling day. It may be sent to me at the following address : ................ ................ Yours faithfully Place ............ Date ............
