FORMID
ECH-EPIC-OOIA
ELECTION COMMISSION OF INDIA
Form for submission of photograph (optional alongwith Form 6 /8 / 8
NAME OF STATE/ UNION TERRITORY rie walk
oa passport siz
(0. NAME OF THE CONSTITUENCY = reeeee
em X33em)
DETAILS OF APPLICANT AS GIVEN IN FORM 6/81 (oworstex
1. NAME OF APPLICANT: Puro)
2, FATHER/MOTHER/HUSBAND'S NAME
4. PARTICULARS OF PLACE OF ORDINARY RESIDENCE (FULL ADDRESS):
[ House! Boor number:
‘Swe ArealLocality/ Mohalla Road
"Town Village
Post Offi
"Tehsil TalukalMandall Thana
Distics Pin Code
| a submitting two copies of my recent passpor size photograph. One pasted on right side top
comer of Form 6 / Form 8 / Form 8A with my signature/TL affixed aeross the photograph . The
‘other photograph has been pasted on this application forthe purpose of preparation of Elector
Photo Identity Card (EPIC).
‘Lam aware that no EPIC will be issued using this photograph if my claim for inclusion in
the electoral roll in Form 6 or for transposition of entry in Form 8A is not accepted and the
photographs will nt be returned to me
oR
‘This photograph may be used to replace wrong photograph appearing in the photo