Government of Goa :Application For Deletion of Name in Electoral

Company Name(s): 

FORM 7
[See rule 13(2) and 26)
Application for objecting inclusion or seeking deletion of name in electoral roll
To
The Electoral Registration Officer,
……………………………Assembly
Parliamentary Constituency.
Sir,
@ I object to the proposed inclusion of the name of the undermentioned person in the electoral roll
for the above Constituency. Particulars in support of my objection are given below:
Or
@ I submit that the entry relating to *myself/ *the person named below is required to be deleted for
the reasons stated hereunder:
Name Surname (if any)
I. @ Details of person
inclusion of whose
name is objected to:
@ Details of person
whose entry is to be
deleted:
Part number of electoral
roll in which his/her
name is included:
His/her serial
number in that
part:
Elector’s Photo Identity
Card number (if issued):
Name Details of objector Surname (if any)
II.
Sex (Male/Female) Part number of electoral roll in which
objector’s name is included:
His/her serial number in that
part:
* Father’s/ Name Surname (if any)
Mother’s/ Name
Husband’s
III. Particulars of place of ordinary residence of @objector/ @person seeking deletion. (Full address)
House/ Door number:
Street/ Area/Locality/Mohalla/Road:
Town/ Village:
Post Office: Pin Code:
Tehsil/ Taluka/Mandal/ Thana:
District:
IV. Reason(s) for *objection/*deletion:
£ In case of Union territories having no Legislative Assembly and the State of Jammu and Kashmir.
@ First alternative will be relevant during preparation/revision of electoral roll. Second alternative will
be relevant during continuous updating after final publication of electoral roll. Strike out the
inappropriate alternative.
* Strike out the inappropriate alternative.
# Part-II not to be filled where applicant seeks deletion of entry relating to himself.

V. Declaration
I hereby declare that the facts and particulars mentioned above are true to the best of my knowledge
and belief.
Place: Date: Signature or thumb impression of the applicant
Please give your mobile number /E-mail I.D(Optional)/……………………………………..
Note- Any person who makes a statement or declaration which is false and which he either
knows or believes to be false or does not believe to be true, is punishable under section 31 of the
Representation of People Act, 1950 (43 of 1950).
* Strike out the inappropriate alternative.
Details of action taken
(To be filled by Electoral Registration Officer of the constituency)
The application of Shri/Smt./Km. …………………………………………………………….
*objecting to inclusion/ *seeking deletion of name of
Shri/Smt./Km……………………………………………. in the electoral roll in Form 7 has been
acepted*/rejected*.
Detailed reasons for *acceptance [under or in pursuance of rule 18*/20*/26(4)
£
] or *rejection [under
or in pursuance of rule 17*/20*/26(4)
£
].
Place: Signature of (Seal of the Electoral
Date: Electoral Registration Officer Registration
Officer)
* Strike out the inappropriate alternative.
£ During continuous updating after final publication of electoral roll.
Remarks of Field Level Officers (e.g BLO, Designated Officer, Supervisory Officer)
Page 2 of 5
[FORM 7 Contd…]
[[This page should be thick enough so that it does not get mutilated /damaged in postal transit]
Intimation of action taken
(Section-II of the page is 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 in Section-I)
----------------------------------------------------------------First Fold-------------------------------------------------------------------------------------------------------------
Section-I
Postage Stamp to be
affixed by the
Electoral Registration
Authority at the time
of dispatch
The application in Form 7 of
**Shri/ Shrimati/ Kumari........
** (Full address)
House/ Door number:
Street/ Area/Locality/
Mohalla/Road:
Town/ Village:
Post Office: Pin Code:
Tehsil/ Taluka/
Mandal/ Thana:
District:
** To be filled in by the applicant.
----------------------------------------------------------------------Second Fold--------------------------------------
Section-II
has been—
(a) accepted and the name of Shri/Shrimati/Kumari.................has been deleted from……………….
Part No.................... of AC No……………………………….
(b) rejected for the reason........................……………………..………………………………………
Date....................... Electoral Registration Officer.
(Address).................
.........................
..........................
………………………………………………..Perforation for detachment……………………………...
Receipt for application
Received the application in Form 7 of ** Shri/Shrimati/Kumari……………………………………..
**Address………………………………………………………………………………………………
Date…………… Signature of the officer receiving the application
on behalf of the Electoral Registration Officer
(Address) ………………………….
** To be filled in by the applicant.

GUIDELINES FOR FILLING UP THE APPLICATION FORM-7
General Instructions
Who can file Form-7
1. Can be filed only by a person whose name is already included in that roll in order to object inclusion of a name
proposed to be included in that part of the electoral roll or for seeking deletion of a name already included in that part of the electoral roll.

When Form-7 can be filed
1. The application can be filed after draft publication of electoral roll of the constituency to object to the proposed inclusion of an entry in the draft roll. The application is to be filed within the specific days provided for the purpose. Due publicity is given about the above period when the revision programme is announced.
2. Only one copy of the application is to be filed.
3. The Application seeking deletion of an entry from the final electoral roll can be filed through out the year even when the revision programme is not going on. During non-revision period, application must be filed in duplicate.
Where to file Form-7
1. During revision period, the application can be filed at the designated locations where the draft electoral roll is displayed (mostly polling station locations) as well as the Electoral Registration Officer and Assistant Electoral Registration Officer of the constituency.
2. During other period of the year when revision programme is not going on, the application can be filed only with the Electoral Registration Officer.
How to Fill up Form-7
1. The application should be addressed to the Electoral Registration Officer of the constituency in which another elector registered in that roll objects the proposed inclusion of an entry in the draft electoral roll. The name of the constituency should be mentioned in the blank space.
2. Details of person inclusion of whose name is objected to / Details of person whose entry is to be deleted :
Out of the two alternative options, the first alternative is relevant after draft publication of electoral roll during revision of electoral roll. In other words to show the objected entry in the draft roll in the list of deletions at the time of final publication of the roll. The second alternative is relevant during continuous updation after final publication of electoral roll. In other words for deletion of an entry already included in the final electoral roll.
(Please strike out the inappropriate alternative while filling up the Form)
Besides the name of the person whose entry is objected for inclusion or sought to be deleted, the other details of the electoral roll Part No., Serial No. of the entry in that Part of electoral roll and Identity Card No issued to that person are also required to be filled up. These details are available in the relevant part of electoral roll. The Part No. of the electoral roll is printed on the right hand top corner of the electoral roll. Every entry is given a serial number. Please check the electoral roll and write the serial number at which the name of the person whose entry is objected for inclusion/sought to be deleted is listed. In case the person has already been issued an Identity Card that No. is also printed against that entry. Please write that card no. in full in the space provided.
Separate Application is required to be filed for objecting inclusion/seeking deletion of each entry.
Please also give your full name and address on the acknowledgement and intimation portions.
Please give your 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.
3. Details of objector
An “Objector” can file Application in Form 7 only in respect of persons included in the part of the electoral roll in which he/she is registered. In Part II of the Application, the objector has to fill up in the space provided his/her name including surname, relation’s name (Father/Mother/Husband), sex, part no. of electoral roll and serial number at which his/her name is registered in that part of the electoral roll.
The Objector must fill up his full address in the space provided in Part III of the Application.
4. Reason(s) for objection / deletion.
In Part IV of the Application, the applicant ‘objector’ must specify the reason(s) as to why according to him/her the person whose name is objected is not qualified for inclusion in that part of electoral roll viz. Due to death, due to shifting, not ordinarily residing at the registered address etc.. The onus of proof to substantiate the reason given for removal of the name lies with the Objector.
5. Declaration
In Part V of the Application the applicant must give a declaration that the facts and particulars mentioned in the application are true to the best of his/her knowledge and belief. Please indicate date from which you are residing in the given address. Giving a false declaration is punishable under section 31 of the Representation of the People Act, 1950.