Date: ____________________

PERSONAL DETAILS

Full Name:
Father's/Husband's Name:
Date of Birth:
Gender:	☐ Male ☐ Female ☐ Other
Contact Number:
Email Address:
Aadhaar Number:

RESIDENCE DETAILS

Unit/Flat/Plot No:
Property ID:	(Format: HR-18-XXXX-XX - State-District-Lot-Section)
Full Address:
Ownership Status:	☐ Owner ☐ Co-Owner ☐ Tenant

OTHER DETAILS

Occupation:	☐ Service ☐ Business ☐ Retired ☐ Student ☐ Other: ________
Qualification:	☐ Below 12th ☐ 12th Pass ☐ Graduate ☐ Post Graduate

PAYMENT DETAILS

Receipt Number:
Payment Date:

DECLARATION

I hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that any false information may lead to rejection of my registration and/or disqualification as a voter. I agree to abide by the rules and bye-laws of Aanchal Vihar RWA.

Date: ____________________

CANDIDATE DETAILS

Full Name:
Voter Card Number:
Unit/Flat/Plot No:
Property ID:	(Format: HR-18-XXXX-XX - State-District-Lot-Section)
Contact Number:
Email:

POSITION APPLYING FOR

☐ President ☐ Vice President ☐ Secretary ☐ Treasurer ☐ Executive Member

EDUCATIONAL QUALIFICATION

Highest Qualification:
Institution Name:
Year of Passing:

PROPOSER DETAILS

Proposer Name:
Proposer Unit No:
Proposer Voter Card No:
Proposer Signature:

SECONDER DETAILS

Seconder Name:
Seconder Unit No:
Seconder Voter Card No:
Seconder Signature:

DECLARATIONS

I, the undersigned candidate, hereby declare that:

☐ I am the sole owner / first owner of the property mentioned above.
☐ I have no pending litigation against the Aanchal Vihar RWA.
☐ I agree to abide by the bye-laws and constitution of Aanchal Vihar RWA.
☐ All information provided in this form is true and correct.
☐ I meet the minimum educational qualification for the position applied.
☐ I understand that false information will lead to disqualification.