Objections to particulars in an entry

FORM 9 [See rules 14(3) and 27] Objections to particulars in an entry To Electoral Registration Officer, ___________________Constituency. I submit that the entry relating to myself which appears at Serial No. _____ _______ in Part No. _________the electoral roll as_____________ is not correct. It should be corrected to read as follows ____________________ Signature of thumb Impression of elector Place_____________________ Date______________________. ______________(Perforation)________________ Intimation of action taken The objection in Form lodged by Shri/Shrimati/Kumari__________________ Address- _______________________________ has been : - (a) accepted and the relevant entry has been corrected to read as follows _______________________________________________________ (b) rejected for the reason_________________________ -' Electoral Registration Officer Date___________________ (Address)_______________________ ____________(Perforatin)____________ Receipt of Application Received the application in Form from Shri/Shrimati/Kumari*_______________ Address*_______________________________________ Date______________ Electoral Registration Officer (Address)_________________ *To be tilled by the applicant.