I. Applicant's details
II. Particulars of place of present ordinary Residence (Full address)
III. Details of elector's photo identity card (if issued, in this or some other constituency)
IV. Upload Supporting Document
V. Details of entries to be corrected*
Note – 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).