form-6

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12/15/2014 FORM6 http://ceoaperms.ap.gov.in/TS_Eregistration/Postal/userdetails.aspx 1/2 Application for inclusion of name in electoral roll ApplicationID:046792946 To, The Electoral Registration Officer *Assembly Constituency: Kukatpally Sir, I request that my name be included in the electoral roll for the above Constituency. Particulars in support of my claim for inclusion in the electoral roll are given below: I. Applicant's Details: Name: VIJAYALAKSHMI : జయల Surname(if any): MANDA ఇంట : మంద Date of birth if you know: Day:01 Month:04 Year:1966 Gender: F Age as on 1st January 2015: Year:48 Months:9 Place of birth Place of birth Village/ Town: HYDERABAD District: RANGAREDDY State: TELANGANA Relation Details Relation Type Father's/Mother's/Husband's: H Name: SATYANARAYANA REDDY : సతయణ Surname(if any): MANDA ఇంట : మంద II. Particulars of place of present ordinary Residence(Full address) House/Door number: 903, MANJEERA TRINITY HOMES Street /Area /Locality /Mohalla /Road: PHASE 3 KPHB, KUKATPALLY /ఏ య/ లట : 3 ,, కకట Town/ Village: HYDERABAD పట ణం/ మం: దబ Tehsil/ Taluka/Mandal/ Thana: BALANAGAR లక /మండలం: బలనగ District: RANGAREDDY Post Office: KUKATPALLY Pin code: 500072

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  • 12/15/2014 FORM6

    http://ceoaperms.ap.gov.in/TS_Eregistration/Postal/userdetails.aspx 1/2

    ApplicationforinclusionofnameinelectoralrollApplicationID:046792946

    To,

    TheElectoralRegistrationOfficer

    *AssemblyConstituency:KukatpallySir,

    IrequestthatmynamebeincludedintheelectoralrollfortheaboveConstituency.Particularsinsupportofmyclaimforinclusionintheelectoralrollaregivenbelow:

    I.Applicant'sDetails:

    Name: VIJAYALAKSHMI :

    Surname(ifany): MANDA :

    Dateofbirthifyouknow: Day:01 Month:04 Year:1966 Gender:F

    Ageason1stJanuary2015: Year:48 Months:9

    PlaceofbirthPlaceofbirth

    Village/Town: HYDERABAD

    District: RANGAREDDY State: TELANGANA

    RelationDetails

    RelationTypeFather's/Mother's/Husband's: H

    Name: SATYANARAYANAREDDY :

    Surname(ifany): MANDA :

    II.ParticularsofplaceofpresentordinaryResidence(Fulladdress)

    House/Doornumber: 903,MANJEERATRINITYHOMES

    Street/Area/Locality/Mohalla/Road: PHASE3KPHB,KUKATPALLY

    //: 3,,

    Town/Village: HYDERABAD /:

    Tehsil/Taluka/Mandal/Thana: BALANAGAR /:

    District: RANGAREDDY PostOffice: KUKATPALLY

    Pincode: 500072

  • 12/15/2014 FORM6

    http://ceoaperms.ap.gov.in/TS_Eregistration/Postal/userdetails.aspx 2/2

    III.Detailsofmember(s)ofapplicant'sfamilyalreadyincludedinthecurrentelectoralrolloftheConstitutency:

    Name: Relationshipwithapplicant:

    RPartnumberoftherolloftheConstitutency:

    SerialnumberinthePart:

    Elector'sPhotoIdentityCardNumber:

    1.PRATAPGANGIREDDYMANDA 0 0 RDV2798959

    2. 0 0

    MobileNo:9700484863 Remarks:

    EmailId:[email protected]

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