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Form 6A

[See rules 8B]


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+91

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  • 2 (a) Reason of being absent from the place of ordinary residence
Employment
Education
Other
  • b) Date from which absenting from ordinary residence in India
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  • Full residential address in the country outside India where currently residing
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I hereby declare that to the best of my knowledge and belief: -

(a) All information given in this application is true.

(b) I am a citizen of India by birth / domicile / naturalisation.

(c) I have not acquired citizenship of any other country.

(d) But for being absent from the place of my ordinary residence in India owing to the reason given in 2(a) above, I would have been ordinarily resident at the address given in my Indian Passport, which has been reproduced at 1(j) above.

(e) I undertake to immediately inform the Electoral Registration Officer through the Indian Mission in the Country of my current residence if I renounce my Indian Citizenship or if I acquire the citizenship of any other country.

(f) I undertake to immediately inform the Electoral Registration Officer through the Indian Mission in the country of my current residence of any change in my residential address in the country of my residence for the records of the Electoral Registration Officer. I understand that any notice sent to me at the address, which is my residential address in the country of my current residence according to the records of the Electoral Registration Officer, shallbe considered as due service of notice to me under the Representation of the People Act, 1950 and the rules made thereunder, and that it is my responsibility to keep the Electoral Registration Officer informed of my latest residential address in the country of my current residence.

(g) If I return to India and become ordinarily resident in India, I shall immediately inform the Electoral Registration Officer of the concerned Assembly/Parliamentary Constituency.

(h) I have not applied for inclusion of my name in the electoral roll of any other constituency.

 (i)My name has not already been included in this or any other constituency.

या/Or

My name may have been included in the electoral roll

I have not been issued an EPIC in India/ have been issued an EPIC which is enclosed with this application for cancellation.

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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).

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