ELECTION COMMISSION OF INDIA

FORM-8A Acknowledgement No.____________

(See Rules 13(4) and 26) of Registration of Electors Rule-1960 (To be filled by office)
Application for Transposition of Entry in Electoral Roll (in case of Shifting from One
Place of Residence to Another Place of Residence within Same Constituency )
SPACE FOR PASTING
To, The Electoral Registration Officer,………………..……………………………………………….…Assembly / Parliamentary Constituency ONE RECENT PASSPORT
I request that entry in the electoral roll for the above mentioned Constituency relating to Myself SIZE PHOTOGRAPH (3.5
CM X 3.5 CM) SHOWING
should be transposed to the relevant part of the roll in this constituency because I have shifted my
FRONTAL VIEW OF FULL
place of ordinary residence within the same constituency. FACE WITHIN THIS BOX
Particulars of the applicant
(a) Name

(b) Surname(if any)

(c) Part No. (d) Serial No.

(d) EPIC No. (if issued)

(e) Email id (optional)

(f) Mobile No. (optional)

(g)Current address of my ordinary residence where I have shifted House No.

Street/Area/Locality

Town/Village

Post Office Pin Code

District State/UT

DECLARATION- I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge
and belief.I am aware that making a statement or declaration which is false and which I know or believe to be false
or do not believe to be true, is punishable under Section 31 of the Representation of the People Act, 1950 (43 of
1950).

Place……………........................

Date……………………………………. Signature of Applicant……….…………………………………………….

Remarks of Field Level Verifying Officer:

Details of action taken

(To be filled by Electoral Registration Officer of the constituency)

The application of Shri/Smt./Km. ……………………………………………………………………. for transposition of entry relating to himself/

herself/ Shri/ Smt. / Km. …………………………………………………………….in the electoral roll in Form 8A has been accepted/rejected.

Detailed reasons for acceptance or rejection [under or in pursuance of rule 26(4)] are given below:

Place:

Date: Signature of ERO Seal of the ERO

Intimation of decision taken (to be filled by Electoral Registration Officer of the constituency and to be posted to the
applicant on the address as given by the applicant)
Postage Stamp
to be affixed by
The application in Form 8A of Shri/Shrimati/Kumari……………………………………………………………………………………………………………..
the Electoral
Current address where applicant is ordinarily residence House No. Registration
Authority at the
Street/Area/Locality time of dispatch

Town/Village
Post Office Pin Code

District State/UT

Has been (a) accepted and the name of Shri/Shrimati/Kumari............................................................................. has been

deleted from Part No …………………………………….. and registered at Sl.No………………………………………. in Part No…………………………

of AC No...........................................

(b) rejected for the reason……………………………………………………………………………………………………………………………………………………….

Date: Electoral Registration Officer

Address……………………………………………….
Acknowledgement/Receipt
Acknowledgement Number _ _ _ _ _ _ _ _ _ _ _ _ _ Date _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Received the application in form 8A of Shri / Smt. / Ms. _______________________________________________________

[ Applicant can refer the Acknowledgement No. to check the status of application].

Name/Signature of ERO/AERO/BLO
 To be appended to Form-8A

;:l '' "

GTIIDELINES FOR FILLING I]P THE APPLICATION
FORM-8A

How to Fill the Form-8A

1. The application should be addressed to the Electoral Registration Officer of the constituency
in which transpositions of the relevant entry is required. The name of the constituency should
be mentioned in the blank space.
2. In Item (a) and (b) )of the Application, the applicant should write his name, as existing in the
electoral roll. In case the initials to applicant's name printed in the electoral roll are in
abbreviated form and he wants them to.be printed in expanded form he can write his full
name in expanded form. The full name except the surname should be written in the first box
and sumame should be written in the second box. In case the applicant does not have a
surname, the given name only should be written. Caste should not be mentioned except where
the caste name is used as part of the elector's name or a surname. Honorific appellations like
Shri, Smt. Kumari, Khan, Begum, Pandit etc. should not be mentioned.

3. Item (c) and (d): Fill the name Part No. & Serial No. of the electoral roll where already
registered and Electors Photo Identity Card No.(EPIC) in full. (as printed in the electoral roll).

4. In item (g) of the Application please mention the complete address of the new place where the
Applicant/person concerned has shifted place of ordinary residence within the constituency.
Please do not write incomplete address as in that case it may not be possible to link the
address to the relevant part of electoral roll where the entry is required to be transposed.

5. Full name and address may also be given on the intimation portions .The Applicant may give
his mobile number and E-mail I.D in the Form, which is optional, as the same, if given, may
be used by the Electoral Registration Officer for further communication with the applicant
whenever required.

Replacement EPIC

If the Applicant wants replacement EPIC with new address, he should apply for the same in
Form EPIC-001 (as per the Format as Annexure I ), with requisite fee for replacement EPIC, and old
EPC, after enrolment at the new place on the basis of Form 8A.
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 . :''*

ANNEXURE I (For Form 8A)

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Election Commission of India FORM ID

(ANNEXURE-II
Application for lssue of Replacement Elector,s photo ldentity Card (EptC)
ECI,EPIC.OOI

A State/ UT :

ACD (No. & Name):

District:

B Elector's Particulars(To be filled by Elector)

To, Sir/Madam,
The Electoral Registration Officer, I request that a Duplicate Electoral photo identity card be issued to me as
my original card is
Assembly/ losudestroyed/mutilated due to corrections in my elector's detail or due to change of address
I want to
Parliamentary$ Constituency get afresh card with my new address. I am retuning my EPIC to you along
with fee for issue of duplicate
EPIC My name is included in the electoral roll for the above constituency. Particulars in support
of my claim
for issue of duplicate EPIC are given below:
1. Name of Elector:
2. EPIC No of
Original card ( if known) :.
3. Fathe/s/ Mother's/
4. Sex (M/F): 5. Date of Birth (DOB) tf not
Husband's'Name :
known then Age in Years)as on
1stJan,200_......
6. Addregs
(i) House / Door number

(il, Drreev Monaili Gali

(ili)Ar"" / L"""lity
(iv) TownA/illage :
(v) PIN CODE
(vi) Police Station :
(vii) District:

(viii) Reasons for apptying

for a Duplicate card

1. lwill collect EPIC from VRC/CSC

2. I wish to receive my Eplc by post(serf addressed and stamped enverope encrosed)
3. lwill collect EPIC from BLO.

)
Signature of the applicant

(ix) fick 1; )the appropriate box:

Date:
lhereby retum my mutilated /old card.
I undertake to retum the earlier card issued to me ff the same Place
ftecovered at a later date.

tr Fot offrcidl Llse

Authen iurionfor Iss. ofEPIC (To belilled by ERO,s Representutive)

Part Serial No. of lD number of Designated photography #Token No. or

No. : Elector in Part: Location (DPL) or Common Service centers Receipt No.
(csE).:
Register No. Serial No. in Register

verfied by:

Date: _/_/200_ Signature

D Acknowledgement of R_ [pIC by the Elector

Received Duplicate EPIC on (Date): Elector's Signature

or Thumb lmpression
200_