Govt of Goa-Form 8A:For Transposition of Entry In Electoral

Company Name(s): 

FORM 8A
[See rule 13(4) and 26)
Application for transposition of entry in electoral roll
To
The Electoral Registration Officer,
……………………………Assembly/
Parliamentary Constituency.
Sir,
I request that entry in the electoral roll for the abovementioned Constituency relating to Myself / person named below should be transposed to the relevant part of the roll in this constituency. Particulars of the entry to transposed are given below:
I. Details of person
whose entry is to be
transposed:
Name Surname (if any)
Part number f electoral roll
in which his/her name is
included:
His/her serial
number in that
part:
Elector’s Photo Identity Card
number (if issued):
Father’s /
Mother’s / Name
Husband’s
Name Surname (if any)
II. Particulars of present place of ordinary Residence (Full address)
House / Door number:
Street / Area / Locality / Mohalla / Road:
Town / Village:
Post Office: Pin Code:
Tehsil / Taluka / Mandal / Thana:
District:
III. Period of continuous residence at the above
address on the date of application
Years: Months:
IV. Part number to which the entry has to be transposed (if known)
@V. Details of
applicant:
Name Surname (if any)
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):
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).
In case of Union territories having no Legislative Assembly and the State of Jammu & Kashmir.
Strike out the inappropriate alternative.
@ Part V not to be filled where applicant seeks transposition of entry relating to himself.
SPACE FOR PASTING
ONE RECENT
PASSPORT SIZE
PHOTOGRAPH
(3.5 CM X 3.5 CM)
SHOWING FRONTAL
VIEW OF FULL FACE
WITHIN THIS BOX

VI. 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)/……………………………………..
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 acepted/rejected.
Detailed reasons for acceptance or rejection [under or in pursuance of rule 26(4)].
Place: Signature of (Seal of the Electoral
Date: Electoral Registration Officer Registration Officer)
Strike out the inappropriate alternative.
Remarks of the field level officers (e.g. BLO, Designated Office, Supervisory Officers)

[FORM 8A 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 8A 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 ………………………. and registered at Sl.No. ----- in 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 8A 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-8A
General Instructions
Who can file Form-8A
1. A person whose name is already included in the current electoral roll can file the Application for transposition of an entry in a different place of the same constituency.

When Form-8A can be filed
1. The application can be filed after draft publication of electoral roll of the constituency .for transposition of entry relating to one own self or someone else within the same constituency. 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. Application for transposition of name within the constituency can also 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-8A
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 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 Part I of the Application Form fill the name Part No. & Sr. No. of the electoral roll where already registered and Electors Photo Identity Card No.(EPIC) in full and the relation’s name (as printed in the electoral roll).
3. In Part II of the Application please mention the complete address of the new place where you/person concerned have 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.
4. In Part III of the Application, indicate the approximate period of continuous residence at the new address mentioned in Part II.
5. In Part IV, write the electoral roll part no. in which the residents of the new area where you have shifted are enrolled. This part is optional in case you don’t know the electoral roll part no., then leave it blank.
6. In Part V is not to be filled where the applicant seeks transposition of entry relating to one own self. This part is required to be filled in case the applicant applies for transposition of entry of some other person.
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.