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VOTER REGISTRATION by

You are NOT REGISTERED until you SIGN and SUBMIT your Voter

Registration Form

EASY INSTRUCTIONS to complete your voter registration: 4. SIGN and SUBMITthe completed form to the Electoral Registration Officer (ERO) of your Assembly

1. PRINT this form.Make sure you print pages 3 and 4 (Form 8) Constituency (AC). You will find your EROs address below.

on one page in back to back print format. This is your

Aplication Form - the official application required by the While submitting your Application Form, do not forget to ask for

Election Commission to register you as a voter. Receipt of Application.

2. FILL additional fields,if applicable. Check Check out www.jaagore.comto join the Jaago Re! movement!

If any fields on Page 4 (eg. Date, Place) are empty and fill

them by hand.

3. ATTACH additional documents. Alongwith your

Application Form, you must also submit the following

documents (if applicable).

a. Address Proof document (if you are applying for correction

in Address details)

b. Identity Proof document (if you are applying for correction

in Name details)

To view the complete list of VALID address proof and

identity/age proof documents, refer to Page 2.

SUBMIT YOUR FORM TO:

Assistant Electoral Registration Officer (AERO) of Assembly Constituency

156-Vikhroli

Smt.H.H.Bhabad

Tahsildar (Encroachment/Removal), Bhandup, Topiwala College Compound, Sarojini Naidu Road, Mulund (W), Mumbai-8

Ph: 25903196 Mob:9869009790

http://www.jaagore.com/

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GENERAL INSTRUCTIONSDOCUMENTS REQUIRED TO REGISTER 5 MYTHS ON VOTING

1. ADDRESS Proof document 1. I am registering to get my voter ID card

This document is required for the BLO (Booth Level Officer) to When you register to vote, you are registering only to get your

come and verify your residence status. It is therefore not name included in the electoral rolls (also called voter list) and

essential for the address proof document to have your name. It NOT to get a voter ID card. To get a voter ID card, you have to

needs to have only the address of the place where you are register separately.

staying. Remember, on election day, only 2 things are mandatory for

Any one of the following documents is acceptable for address you to be allowed to vote:

proof:

Your name should be present on voter list

1. Landline phone bill You should have a valid IDENTITY PROOF. Voter ID card is

2. Mobile telephone bill only one of the valid proofs

3. Water bill

4. Electricity bill 2. I can vote only from the place of my birth / permanent residence

5. Property tax receipt As a citizen of India greater than 18 years of age, you are

6. Bank statement eligible to vote from any place in India, provided you have been

7. Passport an ORDINARY RESIDENT i.e. you have been staying at your

8. Ration card current address for at least 6 months or more.

9. House Lease/Rental agreement

10. LPG receipt 3. I do not have a valid ADDRESS PROOF document to register for

11. Driving license Voting

12. Identity cards given by the employer It is not essential for the address proof document to have your

name. It needs to have only the address of the place where you

2. AGE Proof document name. It needs to have only the address of the place where you

If you are a first time voter, you will also need to submit an age are staying. You can use address proof document on the name

proof document. You can submit the proof of Date of Birth from of your parents, relatives, friends etc. with whom you are

any government agency authorized document like: staying.

1. Birth certificate

2. Passport 4. As a voter, I can vote in 2 kinds of elections State Assembly

3. PAN Card Elections & General Elections

4. Driving Licence As a registered voter you can vote in more than 2 elections!

5. State board exam certificate etc. Besides General and Assembly elections, you can also vote in

your Local Body Elections or Municipal Corporation Elections,

3. For STUDENTS only as called in cities.

If you are a student residing outside your native city in a hostel /

mess, you might not have any of the above mentioned address 5. Registering to Vote is a cumbersome process

proof documents. In this case, you can get a Student Earlier perhaps, but not any more! With Jaago Re!

Declaration Form (Page 5 of this form) signed by your college not only can you fill and submit your registration form

dean/principal/registrar and submit it along with your voter easily, you can also get to know when your name gets on the

registration form. voter list.

And all of this from the convenience of your home!

DISCLAIMER

While all efforts have been made to make all data on the website ( www.jaagore.com )or this Registration Form as error free as

possible, users are requested to refer to the officially published error free copies of the Constitution of India, Acts, Rules and Orders

made there under and to the latest editions of the various Handbooks, Compendia and Reports published by the Election Commission

of India (ECI), for their authentic version. Tata Tea Ltd. will be responsible for any loss to any person caused

by any shortcoming, defect or inaccuracy in the above data. We also do not assure that any particular person will be on the electoral

rolls of ECI.

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FORM 8[See rules 13(3) and 26]

Application for correction to particulars entered in electoral roll

To

The Electoral Registration Officer,

156-Vikhroli Assembly/Parliamentary Constituency.,

Sir,

I request that entry relating to myself appearing in the electoral roll for the above Constituency is not correct and

it should be corrected. Correct particulars in support of my request are given below:-,

I. Applicant's Name Surname (if any)

Details Ashutosh Tripathi

Part number of electoral roll : Serial number in that part :

Age as on 1st January2014# Years: 21 Months: 0 Sex (Male/Female): Male

Date of birth, if known: Day: 05 Month: 01 Year: 1993

Father's/Mother's/Husband's Name Surname (if any)

Tulasi Tripathi

II. Particulars of place of ordinary residence (Full address):

House/Door Number: Room No 272 , Hostel 3

Street/Area/Locality/Mohalla/Road: IIT Bombay

Town/Village: Mumbai

Post Office: Pincode: 400076

Tehsil/Taluka/Mandal/Thana::

District:

III. Details of Electors' Photo Identity Card (if issued, in this or some other Constituency)

Electors' Photo Identity Card number :

Name of the Constituency :

IV. Details of entries to be corrected

*My name / *Age / *Father's/Mother's/Husband's name / *Sex / *Address / *Electors' Photo Identity Card Number

corrected in terms of information provided in this Form above.

Place :

Date : Signature or thumb impression of the electorNote 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 section 31 of the Representation of the People Act, 1950 (43 of 1950).

In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir.

# Please give the year i.e. 2003, 2004, etc.

* Strike out the inappropriate alternative.

P.T.O.

............................................................................(Perforation)............................................................................

Receipt for application

Received the application in Form 8 of ** Shri/ Shrimati/Kumari Ashutosh Tripathi

**Address: Room No 272 , Hostel 3, IIT Bombay, Mumbai 400076.

Date: Signature of the officer receiving the application on

behalf of the Electoral Registration Officer(Address)..........................................................................................

**To be filled in by the applicant.

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

The application of Shri/Smt./Km. .. for

correction of entry in the electoral roll in Form 8 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)

* Strike out the inappropriate alternative

During continuous updating after final publication of electoral roll.