Escolar Documentos
Profissional Documentos
Cultura Documentos
(For Form-6)
DECLARATIONt
(For an elector of 21 + age group seeking fresh registration for the fir.s t
time)
I,. ;;?.~f.l~!.'.~f.l.. · ..-?.~~:.'?.'?.':-: ., Son/Daughter/Wir e of .... 0..~~-'-~.J:!.... Rio ..0.f!J:!J(!(-!_f!_....
.. /-.!J..YfJ.Y.1. .... ...... .... ....... ..... , declare as under: -
2. I have not been issued any EPIC at any time in the past in any constituency.
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Signatu ~ of the Applicant
Place: !3~r--Jli A t.-o P-- £
Date: 1!? - ~f<.c.i--1 - 2 0 ' '1