Handbook for Electoral Registration Officers - Election Commission ...

ANNEXURE 11.3CHAPTER XI PARA 4DeclarationI hereby declare that Mr./Ms____________, son/daughter ofMr./Ms______________________ who has submitted an application for registration asoverseas elector in electoral roll of AC__________ is my _______________ (relationship). Ihereby declare that I have checked all particulars of his/her self-attested documents enclosedwith his/her application in Form 6A and have verified that to the best of my knowledge andbelief they are true. I hereby also verify the signature of the applicant. I am registered as anelector at Sr. No.______ in Part No. ______ of electoral roll of _______ AssemblyConstituency.(Signature of the relative of the applicant)Note:- Any person who makes a statement or declaration which is false and which he eitherknowing or believing to be false or does not believe to be true is committing a punishableoffence under Section 31 of the Representation of the People Act, 1950.251