www.electionin.in

Organisation : Chief Electoral Officer, Karnataka CEO
Facility : Form for submission of photograph (optional) along with Form 6 / 8 / 8A
Applicable State : Karnataka
Home Page : https://ceo.karnataka.gov.in/

CEO Karnataka Form for Submission of Photograph

EPIC 001A Form for submission of photograph (optional) along with Form 6 / 8 / 8A

Related / Similar Service :
Form 4 for New Registration of Electors

CEO Karnataka Get Status of my Application

To download the Form Go to the CEO Karnataka official website and click the Download Forms link

Select the Form EPIC 001A. You can also download it from the below mentioned link.

How to Fill Form?

Fill the below details
Step 1 : Enter Your Name of State / Union Territory [Karnataka]
Step 2 : Enter Your No. & Name of the Constituency [Bangalore North]

Download Form Here : https://www.electionin.in/uploads/168-EPIC001A.pdf

Details of Applicant as given in Form 6 / 8 / 8A :
Step 3 : Enter The Name of Applicant [Pravin]
Step 4 : Enter Your Father / Mother / Husband’s Name [Manjunath]

Step 5 : Enter Your Particulars of place of ordinary residence (full address)
** House/Door number [10A]
** Street/Areal/Locality/Mohalla/Road [Sri ML Subbaraju Rd, Shanthala Nagar]
** Town/village [Sampangi Rama Nagar, Bengaluru]
** Post Office [Karnataka Post Circle]
** Tehsil/Taluka/Mandal/Thana [Bengaluru]
** District [Bangalore]
** Pin Code [560001]

Declaration

I am submitting two copies of my recent passport size photograph. One pasted on right side top corner of Form 6 / Form 8 / Form 8A with my signature/ T.I affixed across the photograph. The other photograph has been pasted on this application for the purpose of preparation of Elector Photo Identity Card (EPIC).

I am 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 not be returned to me.
OR

This photograph may be used to replace wrong photograph appearing in the photo electoral roll against my name as per application for correction made in Form 8.

Step 6 : Enter your Place [Bangalore]
Step 7 : Enter the Date and Signature / T.I. of applicant

Note : Please enclose photocopy of some document like Passport, Driving Licence, Arms
Licence etc. showing your photograph and same address as in the application, if available. Show original for verification at the time of submission of the application and also at the time of field verification or hearing, if required.

For Office Use :
CERTIFIED that I, …… S/o. ……(designation of verifying/attesting officer) have verified the authenticity of the applicant’s photograph with original passport / driving licence / arms licence / others (specify name of document and get one photocopy if not already attached) or on the basis of the statement of Shri / Smt._________________________(name of the person) supporting the authenticity of the photograph, whose name is included in the electoral roll.