राजस्थान रराज&पत्र विशषेाांक RAJASTHAN GAZETTE Extraordinary साअधिकार प्रकाशित Published by Authority भाद्र 5] मगंलवार, िाके 1941 अगस् त 7,, 7119 Bhadra 5, Tuesday, Saka 1941&August 27, 2019 भाग 6 ¼क½ नगरपाशलकाओं सबंिंी ववज्ञप्ततयां आदि। Local Self Government Department NOTIFICATION Jaipur, August 05, 2019 NO.F.8(G) ( )(Rules)DLB/19/31478 .-In exercise of the powers conferred by section 337 of the Rajasthan Municipalities Act, 2009 (Act No. 18 of 2009) and all other powers enabling it in this behalf, the State Government hereby makes the following order further to amend the Rajasthan Municipalities Registration of Electors Order, 1974, namely:-
1. Short title and commencement.- (1) This order may be called the Rajasthan Municipalities Registration of Electors (Amendment) Order, 2019.
(2) It shall come into force on and from the date of its publication in the Official Gazette.
2. Amendment of clause 3.- In clause 3 of the Rajasthan Municipalities Registration of Electors Order, 1974 hereinafter referred to as the said order,-
(i) the existing sub-clause (i) shall be substituted by the following, namely:- "(i) "Act" means the Rajasthan Municipalities Act, 2009 (Act No.
18 of 2009)"; and
(ii) the existing sub-clause (iii) shall be substituted by the following, namely:- "(iii) "Electoral Registration Officer" means the Electoral Registration Officer designated or nominated by the State Election Commission under section 13 of the Act.".
3. Amendment of clause 10.- The existing sub-clause (2) of clause 10 of the said order shall be deleted.
4. Amendment of clause 17.- In sub-clause (4) of clause 17 of the said order, for the existing expression "the Forms 3, 4 and 6", the expression "the Forms 3 and 6" shall be substituted.
616 राजस् थान राज&पत्र, अगस् त 7,] 7119 भाग 6 ¼क½
5. Amendment of clause 17B.- In sub-clause (1) of clause 17B of the said order, for the existing expression "under clauses 12, 13 and 14", the expression "under clauses 12, 13, 14, 17 and 17A" shall be substituted.
6. Deletion of clause 17C.- The existing clause 17C of the said order shall be deleted.
7. Amendment of form 3.- For the existing Form 3 appended to the said order, the following Form 3 shall be substituted, namely.- "FORM- 3 [See Clause 10(1)] Acknowledgment Number: …………… (to be filed by office) Claim Application for inclusion of name in electoral roll To, The Electoral Registration Officer …………………. Municipal Board/Municipal Council/Municipal Corporation.
Sir, I request that my name be included in the electoral roll for the Part no. …..of ward no. …… of Municipal Board/Municipal Council/Municipal Corporation ……………………… As a first time voter or due to shifting from another ward or others Particulars in support of my claim for inclusion in the electoral roll are given below.
Mandatory Particulars
(a) Name
(b) Surname (if any)
(c) Name and surname of Relative of applicant [see item (d)]
(d) Type of relation (Tick appropriate box) Father Mother Husband Wife Other
(e) Age as on 1st January ……… Year Month Days
(f) Date of Birth (in DD/MM/YYYY) Day Month Year
(g) Gender of Applicant (Tick appropriate box) Male Female Third Gender
(h) current address where applicant is ordinarily resident House No.
Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State/UT
(i) Permanent address of applicant House No.
SPACE FOR PASTING ONE RECENT PASSPORT SIZE PHOTOGRA PH (3.5CM X 3.5 CM) SHOWING FRONTAL VIEW OF FULL FACE WITHIN THIS BOX भाग 6 ¼क½ राजस् थान राज&पत्र, अगस् त 7,] 7119 617 Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State/UT
(j) EPIC No. (if issued) Optional Particulars
(k) Disability (if any) Visual impairment Speech and hearing disability Locomotor disability Other ……………………….
(l) Email id
(m) Mobile No./Land Line Details of member(s) of applicant's family already included in the current electoral roll on the Municipal Board/Municipal Council/Municipal Corporation:
Sr. No. Name Relationship with applicant Serial No. of electoral roll Declaration I hereby declare that to the best of my knowledge and belief-
(i) I am a citizen of India and place of my birth is Village/Town ……………………. District ………………………… State ……………………
(ii) I am ordinarily resident at the address given at (h) above since ……………………. (since DD/MM/YYYY)
(iii) I am eligible for the registration of voter list related to above Municipal Board/Municipal Council/Municipal Corporation
(iv) I have not applied for the inclusion of my name in the electoral roll for any other ward of Municipal Board/Municipal Council/Municipal Corporation
(v) *My name has not already been included in the electoral roll for this ward or any other ward of Municipal Board/Municipal Council/Municipal Corporation, or *My name is included in the electoral roll for ward no. ……. serial number in voter list ………….. in which I was ordinarily resident earlier at the address mentioned under. I request that the same may be deleted from that electoral roll.
Place:
Date:
Signature or thumb impression of the applicant (with name and address) *strike off the option not appropriate Address of earlier place of ordinary residence (if applying due to shifting from another ward of Municipal Board/Municipal Council/Municipal Corporation) House No.
Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State/UT EPIC No. (if issued) 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 15 of the Rajasthan Municipalities Act, 2009.
Place:
Date:
Signature or thumb impression of the applicant (with name) 618 राजस् थान राज&पत्र, अगस् त 7,] 7119 भाग 6 ¼क½ Details of action taken on Application Remarks of Field Level Verifying Officer (officer working on behalf of the Electoral Registration Officer) Details of action taken (To be filled by Electoral Registration Officer) The application of Shri/Shrimati/Kumari ……………………………………… for the inclusion of name in the electoral roll in Form-3 has been *accepted/*rejected.
Detailed reasons for acceptance or rejection under or in pursuance of clause 12 of the Rajasthan Municipalities Registration of Electors Order, 1974.
Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) *strike off the option not appropriate 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) The application in Form-3 of shri/ Shrimati/ Kumari ………………………………… Present address where applicant is ordinarily resident.
House No.
Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State Has been-
(a) accepted and the name of Shri/Shrimati/Kumari ……………………………………. has been registered at serial number ………………. in ward No. ………………….. of Panchayat Circle …………………………….
(b) rejected for the reason ……………………………………………… Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) Postage Stamp to be affixed by the ERO at the time of dispatch भाग 6 ¼क½ राजस् थान राज&पत्र, अगस् त 7,] 7119 619 Acknowledgement/Receipt Acknowledgment Number: …………………………… Date…………………………..
Received the application in Form-3 of Shri/Smt./Kumari ………………………………………………..
Address …………………………………………………………… (Applicant can refer the acknowledgemnt No. to check the status of application) Signature of Officer receiving the application on behalf of the Electoral Registration Officer (Name and Post of the Officer)
8. Deletion of form 4.- The existing Form 4 appended to the said order shall be deleted.
9. Amendment of form 5.- For the existing Form 5 appended to the said order, the following Form-5 shall be substituted, namely.- "FORM-5 [See clause 10(3)] Acknowledgment Number: …………… (to be filed by office) Application for objecting inclusion of name in electoral roll To, The Electoral Registration Officer …………………. Municipal Board/Municipal Council/Municipal Corporation.
Sir, I hereby object to the proposed inclusion of the name of the under mentioned person in the electoral roll I hereby request that entry relating to name of the person mentioned below is required to be deleted I request that the entry relating to myself is to be deleted from Electoral Roll Particulars in support of my objection/deletion are given below:- Particulars of applicant Name Surname (if any) Name of Father/Mother/Husband Ward No. Part No. Serial Number of rolls EPIC No. (if issued) Details of person inclusion of whose name is objected to/whose entry is to be deleted:
Name Surname (if any) 620 राजस् थान राज&पत्र, अगस् त 7,] 7119 भाग 6 ¼क½ Name of Father/Mother/Husband Ward No. Serial Number of rolls EPIC No. (if issued) Reason(s) for objection/deletion 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 15 of the Rajasthan Municipalities Act, 2009.
Place:
Date:
Signature or thumb impression of the applicant (with name and address) Details of action taken on Application Remarks of Field Level Verifying Officer (officer working on behalf of the Electoral Registration Officer) Details of action taken (To be filled by Electoral Registration Officer) The application of Shri/Shrimati/Kumari ……………………………………………………………………….. objecting to inclusion/ seeking deletion of name of Shri/Shrimati/Kumari………………………………………… in the electoral roll in form-5 has been accepted/rejected.
Detailed reasons for acceptance or rejection under or in pursuance of clause 12(1) of the Rajasthan Municipalities Registration of Electors order, 1974 are given below:
Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) Intimation of decision taken (to be filled by Electoral Registration Officer and to be posted to the applicant on the address available in the record) The application in Form II of shri/ Shrimati/ Kumari ………………………………… भाग 6 ¼क½ राजस् थान राज&पत्र, अगस् त 7,] 7119 621 Present address of ordinary Residence as mention in application.
House No.
Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State/UT Has been
(a) accepted and the name of Shri/Shrimati/Kumari ……………………………………. has been deleted from serial number ………………. in ward No. ………………….. Municipal Board/Municipal Council/Municipal Corporation …………………………….
(b) rejected for the reason ……………………………………………… Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) Acknowledgement/Receipt Acknowledgment Number: …………………………… Date…………………………..
Received the application in Form-II of Shri/Smt./Kumari ………………………………………………..
Address …………………………………………………………… (Applicant can refer the acknowledgement No. to check the status of application) Signature of Officer receiving the application on behalf of the Electoral Registration Officer (Name and Post of the Officer) "
10. Amendment of form 6.- For the existing Form 6 appended to the said order, the following Form 6 shall be substituted, namely.- "FORM-6 [See clause 10(4)] Acknowledgment Number: …………… Postage Stamp to be affixed by the ERO at the time of dispatch 622 राजस् थान राज&पत्र, अगस् त 7,] 7119 भाग 6 ¼क½ (to be filed by office) Application for correction to particulars entered in electoral roll To, The Electoral Registration Officer …………………. Municipal Board/Municipal Council/Municipal Corporation.
Sir, I request that entry relating to myself appearing in the electoral roll of ward no. ………Municipal Board/Municipal Council/ Municipal Corporation ………… is not correct and it should be corrected.
Applicant's details
(a) Name Surname (if any)
(c) Details of registration with electoral roll Ward No. Part No.
Serial No.
(d) EPIC No. (if issued)
(e) please tick the entry which is to be corrected Name Photograph Address Date of Birth Age Name of Relative Type of Relation Gender
(f) The correct particulars in entry to be corrected are as below:
(g) Email id (optional)
(h) Mobile/Land line No.
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 15 of the Rajasthan Municipalities Act, 2009.
Place:
Date:
Signature or thumb impression of the applicant (with name and address) Details of action taken on Application Remarks of Field Level Verifying Officer (officer working on behalf of the Electoral Registration Officer) SPACE FOR PASTING ONE RECENT PASSPORT SIZE PHOTOGRAPH (3.5CM X 3.5 CM) SHOWING FRONTAL VIEW OF FULL FACE WITHIN THIS BOX भाग 6 ¼क½ राजस् थान राज&पत्र, अगस् त 7,] 7119 623 Details of action taken (To be filled by Electoral Registration Officer) The application of Shri/Kumari ……………………………………… for correction of entry in the electoral roll in Form-6 has been accepted/rejected.
Detailed reasons for acceptance or rejection under or in pursuance of clause 12(1) of the Rajasthan Municipalities Registration of Electors order, 1974.
Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) *strike off the option not appropriate 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 available in records/given by applicant) The application in Form-6 of shri/ Shrimati/ Kumari ………………………………… Present address where applicant is ordinarily residence.
House No.
Street/ Area/Locality Town/Village Tehsil Panchayat Samiti Post Office Pin Code District State Has been
(a) accepted and the entry at Sr. No. …………of Part no……. of Ward no…………… Municipal Board/Municipal Council/Municipal Corporation …………………….has been modified accordingly
(b) rejected for the reason ……………………………………………… Place:
Date:
Signature Electoral Registration Officer (Name and Seal of Electoral Registration Officer) Acknowledgement/Receipt Acknowledgment Number: …………………………… Date…………………………..
Postage Stamp to be affixed by the ERO at the time of dispatch 624 राजस् थान राज&पत्र, अगस् त 7,] 7119 भाग 6 ¼क½ Received the application in Form-6 of Shri/Smt./Kumari ………………………………………………..
Address …………………………………………………………… (Applicant can refer the acknowledgment No. to check the status of application) Signature of Officer receiving the application on behalf of the Electoral Registration Officer (Name and Post of the Officer) " By Order of the Governor, Ujjwal Rathore, Director cum Joint Secretary राज्यके्रीयरणर,ाजयपजयपणर