Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697804233263.pdf (India)
Date of notification- ELECTION COMMISSION OF INDIA Form-7 FORM No.

(To be filled by office) Voter Application Form for Objection for Proposed Inclusion/ Deletion of Name in Existing Electoral Roll (See Rules 13(2) and (26) of the Registration of Electors Rules-1960) To, The Electoral Registration Officer, No.

& Name of Assembly Constituency Or No.

& Name of Parliamentary Constituency@ No.

No.


Name Name (@ only for Union Territories not having Legislative Assembly) I submit application for objection for proposed inclusion/deletion of name in existing electoral roll.

(1) Name of the applicant EPIC No.

Mobile No.

of Self ‘or’ Mobile No.
of Relative (2) Option of application/objection:- (Tick the appropriate option) (Any one) (i) I request to delete name of the person mentioned below already included in the current roll due to any one of the following reasons:- (tick any one) Death Under Age Absent / Permanently shifted Already enrolled Not Indian Citizen (ii) I object to proposed inclusion of name of the person mentioned below due to any one of the following reasons - (tick any one) Death Absent / Permanently shifted Under Age Already enrolled Not Indian Citizen (iii) I request to delete my name from electoral roll due to any one of the following reasons-(tick any one) Permanently shifted Already enrolled Not Indian Citizen Death Certificate attached (Tick the appropriate option) Yes No (3) The details of the person in respect of whom objection has been raised, are as below:- Name Surname EPIC No.
(if available) _ Address House/Building/ Apartment No.
Town/Village PIN Code District Street/Area/Locality/ Mohalla/Road Post Office Tehsil/Taluqa/Mandal State/UT DECLARATION I HEREBY DECLARE that to the best of my knowledge and belief that I am aware that making a statement or declaration which is false and which I know or believe to be false or do not believe to be true, is punishable under Section 31 of Representation of the People Act,1950 (43 of 1950) with imprisonment for a term which may extend to one year or with fine or with both.
Date: Place: Accessibility Instructions:- In the light of provisions of Rights of Persons with Disabilities Act 2016 and Rights of Persons with Disabilities Rules, 2017, in case of persons with intellectual disability, autism, cerebral palsy and multiple disabilities etc., signature or left hand thumb impression of person with disability, or signature or left hand thumb impression of his/her legal guardian will be required.
 Acknowledgement/Receipt for application  Signature of Applicant/Thumb Impression Acknowledgment Number Received the application in Form 7 of Shri/Smt./Ms.

[Applicant can refer the Acknowledgement No.

to check the status of application.]

Date Name/Signature of ERO/AERO/BLO To be appended to Form-7 GUIDELINES FOR FILLING UP THE APPLICATION FORM-7 1.

General Instruction:- (a) The application can be made by an elector registered in the existing electoral roll of the constituency.
(b) The application can be an objection in respect of a registered elector/ an objection to the proposed inclusion of an entry in the electoral roll of the constituency, in which the applicant himself is registered OR a request for deletion of the applicant's own name from electoral roll.

2.

Item No.

1 (Name of the applicant)-The applicant shall mention his name, EPIC no.

and mobile number of self ‘or’ relative (father/mother/husband/legal guardian).

3.

Item No.
3.

Item No.

2 (Option of objection/application of deletion):-The applicant has to tick any one option for which he intends to make the application.

He must also tick any one of the reasons mentioned below the option, as to why according to him, the person against whom the objection has been made, is not qualified for inclusion in the electoral roll viz.
due to death, under age, absent/permanently shifted, already enrolled in the electoral roll at the same place or some other place, not an Indian citizen etc.

The onus of proof to substantiate the reason given for objection or removal of name lies with the applicant.

4.

Item No.

3 (Details of the person in respect of whom objection has been made):-The applicant has to fill up the name, surname, EPIC number and address of the person whose entry is objected to for inclusion or sought to be deleted.

5.
5.

DECLARATION:-The applicant must give a 'DECLARATION' that the facts and particulars mentioned in the application are true to the best of his/her knowledge and belief.

Please note that giving any false statement made in the DECLARATION portion is a punishable offence under Section 31 of the Representation of People Act, 1950 with imprisonment with a term which may extend to one year or with fine or with both.

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