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5 6 FORM 11 (Seerule16) List of objections to inclusion of names Date of receipt Serial Number Full name if objector Particulars of name objected to Reasons in brief for objection Date, time and place of hearing Part No. Serial No. Name In full 1 2 3 4 5 6 7 8 FORM12 (SeeRule16) List of objections to particulars in entries Date of receipt Serial Number Name in full of elector objecting Part No.and Serial No. of entry. Nature of objection Date, time and place of hearing 1 2 3 4 5 6 FORM No.13 (See rule 19) Notice of hearing of a claim Duplicate Original copy To Full Name and Address of claimant____________________________________ ___________________________________ ____________________________________ Reference: Claim No.___________________________________ Take notice that your claim for the inclusion of your name in the electoral roll will be heard at ________________ (place) at______________O'clock on the _____________day of_____19, You are directed to be present at the hearing with such evidence as you may like to adduce. Place_______________ ____________________________ Date_______________ Electoral Registration Officer FORM 13 (See rule 19) Notice of hearing of a claim Duplicate To be served on the claimant To (Full Name and address of claimant)____________________________________ ___________________________________ ____________________________________ Reference: Claim No.___________________________________ Take notice that your claim for the inclusion of your name in the electoral roll will be heard at ________________ (place) at______________O'clock on the _____________day of_______________________19, You are directed to be present at the hearing with such evidence as you may like to adduce. Place_______________ Date_______________ Electoral Registration Officer CERTIFICATE OF SERVICE OF NOTICE Received notice of the date of hearing Date:___________________ Claimant Certified that the notice on the claimant has been duly served by me this_______ day of________ on (name)____________________ personally/by affixation on residence. Place___________________ Date _________________ _____________ Serving Officer. Note.- If this notice is served by post, attach receipt here. FORM 14 (See Rule 19) NOTICE TO THE OBJECTOR Duplicate Office copy To (Full name and address of objector)_________________________ Reference:- Objection No.________________________________ Take notice that your objection for the inclusion of the name of ______________________________________________________________ Will be heard at __________________ (place) at _____________ O'clock on the_____ day of ________199. You are directed to be present at the hearing with such evidence as you may like to adduce. Place_________________ Date__________________ _____________________ Elector Registration Officer FORM 14 (See Rule 19) NOTICE TO THE OBJECTOR Original To Be served on the objector To (Full name and address of objector)_________________________ Reference:- Objection No.________________________________ Take notice that your objection for the inclusion of the name of ______________________________________________________________ Will be heard at __________________ (place) at _____________ O'clock on the_____ day of ________199. You are directed to be present at the hearing with such evidence as you may like to adduce. Place_________________ Date__________________ Electoral Registration Officer. FORM 15 (See Rule 19) (NOTICE TO THE PERSON IN RESPECT OF CLAIM OBJECTION HAS BEEN MADE) Duplicate (Office Copy) To Full name and address of person_______________________ object to___________________________________________________ Reference: Objection No.________________________________ Take notice that the objection for the inclusion of your name at Serial No. in part ______________ of the electoral roll for_______________ constituency tiled by. (Full name and Address of Objector)__________________________________ Will be hear that_______________ (place) at ________ O'clock on The__ ______ day of_______ 199 . You are directed to be present at the hearing with such evidence as you may like to adduced. The ground of objection (in brief) area:- (a) (b) (c) Place_________________ Date_________________ Electoral Registration Officer FORM 15 (See Rule 19) (NOTICE TO THE PERSON IN RESPECT OF CLAIM OBJECTION HAS BEEN MADE) Original To be served on the objector To Full name and address of person_______________________ Objected to___________________________________________________ Reference: Objection No.________________________________ Take notice that the objection for the inclusion of your name at Serial No. in part ______________ of the electoral roll for_______________ constituency filed by. (Full name and Address of Objector)__________________________________ Will be hear that_______________ (place) at ________ O'clock on The__ day of_______ 199 . You are directed to be present at the hearing with such evidence as you may like to adduced. The ground of objection (in brief) area:- (a) (b) (c) Place_________________ Date_________________ Electoral Registration Officer CERTIFICATE OF SERVICE OF NOTICE Received Notice of the date of hearing Date________________ Person objected to, Certified that the notice on the person, the entry relating to whose name has been objected to, has been duly served by me this_______ day of __________on (name)____________________ personally/by affixation on residence. Place______ Date__________ Serving Officer. N.B.- If this notice is served by post, attach the receipt here FORM 15-A (SEE RULE 19) Notice of Hearing of an Objection to Particulars in An Entry Duplicate Office copy To (Full name and address of objector __________________________________ Reference :- Objection No,___________________________________________ Take notice that your objection to certain particulars in the entry relating to you will be heard at___________ (place) at __________ O'clock on the day of _________ 19 .You are directed to be present at the hearing with such evidence as you may like to adduce. Place______________ Date ______________ Electoral Registration Officer FORM 15-A (SEE RULE 19) Notice of Hearing of an Objection to Particulars in An Entry Original To be served to the objector To (Full name )_________________________ and address of objector __________________________________ Reference :- Objection No,___________________________________________ Take notice that your objection to certain particulars in the entry relating to you will be heard at___________ (place) at __________ O'clock on the____________________________day of _________ 199 .You are directed to be present at the hearing with such evidence as you may like to adduce. Place______________ Date ______________ Electoral Registration Officer CERTIFICATE OF SERVICE OF NOTICE Received Notice of the date of hearing Date_______________________ Objector Certified that the notice on the person, the entry relating to whose name has been objected to, has been duly served by me this_______ day of __________on (name)____________________ personally/by affixation on residence. Place______ Date__________ ___________ Serving Officer. N.B.- If this notice is served by post, attach the receipt here. FORM 16 (SeeRule23) Notice of Final Publication of Electoral Roll It is hereby notified for public information that the list of amendments to the draft electoral roll for the____________________________ constituency of____________Municipal Corporation/Council/Nagar Panchayat has been prepared with reference to___________ as the qualifying copy of the said roll together with the said list of amendment has been published and will be available for inspection at my office. Place__________ Date___________ _____________ Electoral Registration Officer Adress________________ FORM 17 (See rule 27) Application for transposition of entry in electoral roll To The Electoral Registration Officer, ___________________Constituency. Sir, I submit that the entry at Serial No._________________________ in Part No, _________________of the electoral roll for the above mentioned constituency relating to (myself, namely)________________________ son/wife/daughter of___________________ should be transposed to Part No, ______________of the roll, because I have changed my place of ordinary residence which is within the same constituency. I declare that I am an elector of this constituency being enrolled at Serial No.__________________ in Part No._____________ of the roll. Place____________ Date_____________ Signature/thumb-Impression Full Postal Address__________ ________________ (Preforation)_________________ Intimation of action taken The application in Form 17 of Shri/Shrimati/Kumari_________________ ___________________Adress______________________has been_________ (a) accepted and the name of Shri/Shrimati/kumar____________________ has been transposed to part no.____________________ (b) rejected for the reason____________________________ Date________________ ______________________________ Electoral Registration Officer (Address)___________________ ________________ (Preforation)_________________ Receipt the application in Form 17 from Shri/Shrimati/Kumari_________________ Address_______________________________________ Date:_____________ Electoral Registration Officer (Address)________________ To be filled in by the applicant. FORM 18 (See Rule 27) Application for Deletion of Entry in Electoral Roll To The Electoral Registration Officer, ______________________constituency, Sir, I submit that the entry at Serial No,____________________in Part No. ___________________ of the electoral roll for the above mentioned constituency related to Shri/Shrimati/Kumari_____________________ son/wife/daughter of__________________ requires to be deleted as the said person is dead/is no longer ordinarly resident in this locality/is not entitled to be registered in the electoral roll for the following reasons:- _______________________________________________________________________________ _____ I hereby declare that the facts mentioned above are true to the best of my knwoledge and belief. I declare that I am an elector of this constituency, being enrolled at Serial No, _____________ in Part No. -------------- of the roll. Date ___________________ Place____________________ _______________________________ Signature/Thumb-impression of Objector Full Postal Address_________________ *strike out the inappropriate words. __________________________(Perforation)______________________ Intimation of action taken The application in Form 18 lodged by Shri/Shrimati/Kumar___________________________Address___________________has been____________________________________________________ (a)accepted and the name of Shri/Shrimati/Kumari______________________as appearing at Serial No.in Part No.__________________________________has been dated. (b)rejected for the reason__________________________________________ Date:________________________ ______________________ Electoral Registration Officer Address_________________ __________________(Perforation)_________________________ Receipt for application Received the application in Form 18 from Shri/Shrimati/Kumari*_________ Address_____________ Date________________ _____________ Electoral Registration officer Address_______________ *To be filled by applicant. FORM 19 [See Rule 34] NOTICE OF ELECTION Notice is hereby given that: (1) an election is to be held of a member to Municipal Corporation/council/Nagar Panchayat from constituency No. (2) nomination papers may be delivered by a candidate of his proposer to me at _______ between 11 A.M. and 3 P.M. on any day (other than public holiday) not later than_____________ (3) forms of nomination paper may be obtained at the place and times aforesaid, (4) the nomination papers will be taken up for scrutiny at________________ on--------------------- ---at_______________________ (5) notice of withdrawal of candidature may be delivered by a candidate or his proposer or his election agent (who has been authorized in writing by the candidate to deliver it) to me before 3 P.M. on the _______________ (6) in the event of the election being contested, the roll will be taken on______ between hours of _______________ and____________ Place__________ Date___________ Returning Officer. FORM 20 [See Rule 36] NOMINATION PAPER I nominate as a candidate for election to the Municipal Corporation/Municipal Council/Nagar Panchayat______________ from constituency No___________________. Candidate's Name_____________________father's/husband's name_________________His postal Adress _____________________________________________________________ His name is entered at Serial No._______________ in Part No. ____-_______ of the election roll for____________ constituency No._____________ My name is______________________ and it is entered at Serial No.____________in Part No. ___________ of the electoral rolls for________ constituency No.__________ Date _________ (Signature of proposer) I, the above mentioned candidate, assent to this nomination and hereby declare: (a) that I have completed____________________years of age; (b) that I am (set up) at this election by the ___________ party; (C) that the symbols I have chosen are in order of preference (i) _________ (ii) _______and________ (iii) (d) that my name and my father's/husband's name have been correctly spelt out above in __________ (name of the language). (e) that to the best of my knowledge and belief, I am qualified and not also disqualified for being chosen to fill the seat in the Municipal Corp oration/Council/Nagar Panchayat. I further declare that am a member of the _______________*_caste/which is Scheduled *caste/backward Class______________ in relation to___________ (area in that State). Date__________ (Signature of the Candidate) I have examined this nomination paper in accordance with Section 38 and decide as follows: Returning Officer Date_________________ __________________Perforation)____________________ Receipt for Nomination paper and Notice of Scrutiny (To be handed over to the person presenting the nomination paper) Serial No. of nomination paper__________________ The nomination paper of _______________ a candidate for election from the _______________constituency was delivered to me at my office at _____ (hour) on _______ )date)* by the candidate/proper. All nomination papers will be taken up for scrutiny at___________ (hour) On_____ (date) at ___________ ________ (place). Returning Officer Dated__________________ *Score out the word not applicable. FORM 21 [SeeRule38] NOTICE OF NOMINATION Election to the Municipal Corporation/Council/Nagar Panchayat__________ From __________ Constituency. Notice is hereby given that the following nominations in respect of the above election have been received ucto 3 P.M. today:- Sr.No of nominatio n paper Name of candida te Iname of father/ husband Age of candid ate adres s Party Affiliati on Particular sof castes for candidate s belonging to schedule d Cates Electoral roll number of candidat e Name of Propo ser Electoral roll number of propose r 1 2 3 4 5 6 7 8 9 10 Place______________ Date______________ Returning Officer FORM 22 (See Rule 40) List of Validly Nominated Candidates Election to the ____________Municipal Corporation/Council/NagarPanchayat. Serial Number Name Name of Candidate Name of Father/ Husband Address of Candidate Party affiliation 1 3 4 5 Place____________ Date_____________ Returning Officer FORM 23 (See Rule 41) Notice of withdrawal of Candidate Election to the Municipal Corporation/Council/Nagar Panchayat The Returning Officer I___________________ a candidate validly nominated at the above election do hereby give notice that I withdraw my candidature. Place______ Date___________________ Signature of (validly nominated candidate) This notice was delivered to me at my office at________ (hour) on______ (date) by_________________ (name) the ______________ Date_________ Returning Officer Receipt of Notice of Withdrawal (To be handed over to the person delivering the notice) The notice of withdarwal of candidature by _______________ a (validly nominated candidate) at the election to the___________________ was delivered to me by the at my office at ________(hour) on ___________(date). Returning Officer FROM 23-A (See Rule 41) Notice of withdarwal of Candidature Election to the Municipal Corporation/Council/Nagar Panchayat_____________ Notice is hereby given that the following validly nominated candidate/candidates) at the above election, withdraw his candidature/their candidatures today:- Name of (validly nominated Address of (validly nominated Remarks Candidate) candidate)