ఎన్ని కలు 2024

PARLAMENT (WHITE) ASSEMBLY (PINK)

ACPT12345 ACPT12345
CU No. CU No.
BURE54687 BUCY12345
BU No. BU No.
VZXT02657 VZUE12345
VVPAT No VVPAT No

PARLAMENT
Type of Material Supplied Used Un Used
From To Total From To Total From To Total
Green Paper Seals
Pink Paper Seals
Special Tags
Address Tags
Tender Ballot Papers

DVR
 ఎన్ని కలు 2024

ASSEMBLY
Type of Material Supplied Used Un Used
From To Total From To Total From To Total
Green Paper Seals
Pink Paper Seals
Special Tags
Address Tags
Tender Ballot Papers

Allotted to total Male Femal 3rd Total Grand %

Voters e Gender Total
Polled Votes
7 AM To 9 AM
9 AM To 11 AM

11 AM To1 PM

1 PM To3 PM

3 PM To5 PM

5 PM To END

TOTAL
 ANNEXURE-8
CHAPTER-I, Para 1.12
FORM 17C (2 + 2 + AGENTS)
PART I – ACCOUNT OF VOTES RECORDED
Election to House of the People/Legislative Assembly of the State/Union Territory ………………………
…….from ………………………… constituency
Number and Name of the Polling Station :
Identification Number of voting Machine used at the Polling Station :
Control Unit _________
Balloting Unit _________
VVPAT _________
1. Total number of electors assigned to the Polling Station :
2. Total number of voters as entered in the Register for Voters (Form 17A) :
3. Number of voters deciding not to record votes under rule 49-O :
4. Number of voters not allowed to vote under rule 49M :
5. Test votes recorded under rule 49MA (d) required to be deducted.
(a) Total number of test votes to be deducted :
Total No. Sl. No(s) of elector(s) in Form 17A
………….. ………….
(b) Candidate(s) for whom test vote(s) cast :
Sl.No. Name of candidate No. of votes
……. ………………………. ………
…….. ……………………… ……….
6. Total number of votes recorded as per voting machine : DVR
7. Whether the total number of votes as shown against item 6 tallies with the total number
of votes as shown against item 2 minus numbers of voters deciding not to record votes as
against item 3 minus number of voters as against item 4(i.e. 2-3-4) or any discrepancy
noticed ……………………..
8. Number of voters to whom tendered Ballot papers were issued under rule 49P ………..
9. Number of tendered Ballot papers :
Sl. No.
Total From To
(a) received for use
(b) issued to electors
(c) not used and returned
10. Account of papers seals Signature of polling Agents
1. Paper seals supplied for use Total No ………… 1. ………………..
Sl.No. From ………. To …………….. 2. ………………..
2. Paper seals used Total No …………. 3. ……………….
Sl.No. From ………. To …………….. 4. ………………..
3. Unused paper seals returned to Returning Officer
Total No …………. 5. ……………….
Sl.No. From ………. To …………….. 6. ………………..
4. Damaged paper seal, if any: Total No …………. 7. ……………….
Sl.No. From ………. To …………….. 8. ………………..
Date ……………….
Place …………………….
Signature of Presiding Officer
Polling Station No. …………………..
 17A రిజిస్ర్
ట

క్క.స్ం. ఎలక్టటరల్ ఓటరుు ఓటరు రిమారుక లు

రోల్్ లో అతను/ఆమె స్ంతకం/బొట
ఓటరు గురి తంపుకు నవేలు ముక్ర
తెచ్చి న పక్తం
స్ంఖ్య
యొకక వివరాలు
(1) (2) (3) (4) (5)
Total in the Control Units checked and found it be “ZERO”

The Serial number of the last entry in the 17A is 863

 PRESIDING OFFICER’S DIARY (ANNEXURE-7) (2Copies)
1. Name of the constituency :
2. Date of poll :
3. Number and name of the polling station :
whether located in
i) Government or quasi-government building :
ii) Private Building :
iii) Temporary structure :
4. Number of Polling Officers recruited locally, if any :
5. Appointment of Polling Officer made in the absence of duly appointed Polling
Officer, if any, and the reasons of such appointment :
6. Electronic Voting Machine
(i) Number of Control Units used :
(ii) S.No.(s) of Control Units used :
(iii) number of Balloting Units used :
(iv) S.No.(s) of Balloting Units used :
7. (i) Number of paper seals used :
(ii) S.No.(s) of paper seals used :

DVR
7A (i) number of special tags supplied :
(ii) S.No.(s) of special tags supplied :
(iii) number of special tags used :
(iv) S.No.(s) of special tags used :
(v) S.No.(s) of special tags returned as unused :
7B Applicable in the polling stations where VVPAT system is used
(i) No. of Printers used :
(ii) S.No.(s) of printer(s) :
8. Number of candidates who had appointed polling agents at the polling stations :
9. (i) Number of polling agents present at the commencement of poll :
(ii) Number of polling agents who arrived late :
(iii) Number of polling agents present at the close of the poll :
10. (i) Total number of voters assigned to the polling station :
(ii) Number of electors allowed to vote according to marked copy of the electoral roll :
(iii) Total number of electors as entered in the Register of Voters (Form 17-A) :
(iv) Number of votes recorded as per the voting machine :
(v) Number of voters deciding not to record vote, if any :

Signature of the first Polling Officer Signature of the first Polling Officer
In-charge of Register of Voters
11. Number of electors who voted –
Men :
Women :
Third Gender :
Total :
12. Challenged vote-
Number allowed :
Number rejected :
Amount forfeited Rs. :
13. Number of persons who have voted on production of Election Duty Certificate (EDC) :
13A . Number of overseas electors who voted :
14. Number of electors who voted with the help of companions :
15. Number of voters cast through proxy :
16. Number of tendered votes :
17. No. of electors –
(a) From whom declarations as to their age obtained :
(b) Who refused to give such declaration :
18. Whether it was necessary to adjourn the poll and if so, the reasons for such
adjournment :
19. Number of votes cast in every two hours –
From 7 a.m. to 9 a.m. :
From 9 a.m. to 11 a.m. :
From 11 a.m. to 1 p.m. :
From 1 p.m. to 3 p.m. :
From 3 p.m. to 5 p.m. :
19B. Details of visitors at polling stations as per Visit Sheet

S.No Name & Designation of the officer Time of Brief description of Number of votes
. visiting Visit polling process polled till the time of
(Observer/DEO/RO/ARO/Sector (Peaceful/Incident, if Visit
Magistrate/Zonal any)
As per As per
Magistrate/Patrolling Magistrate)
Form 17 the EVM
1

20. (a) Number of slips issued at the closing hour of the poll to electors standing in the queue :
(b) Time at which poll finally closed after the last such elector cast his/her vote :
21. Electoral offences with details :
Number of cases of –
(a) Canvassing within one hundred meters of the polling station :
(b) Impersonation of voters :
© Fraudulent defacing , destroying or removal of the list of notice or other documents at the
polling station :
(d) Bribing of voters :
(e) Intimidation of voters and others persons :
(f) Booth capturing :
22. Was the poll interrupted or obstructed by –
(a) Riot :
(b) Open violence :
© Natural calamity :
(d) Booth capturing :
(e) Failure of voting machine :
(f) Any other cause :
Please give details of the above.
23 Was the poll vitiated by any voting machine used at the polling station having been –
(a) Unlawfully taken out of the custody of the Presiding officer :
(b) Accidently or intentionally lost or destroyed :
( c) Damaged or tampered with :
please give details.
24. Serious complaints, if any, made by the candidate/agents :
25. Number of cases of breach of law and order :
26. Report of mistakes and irregularities committed, if any, at the polling station :
27. Whether the declarations have been made before the commencement of the poll and if
necessary, during the course of poll when a new voting machine is used and at the end of the
poll as necessary :

Place : :
Date : Presiding Officer

DVR
 ANNEXURE-5
(Chapter-I, Para 1.12)
PRESIDING OFFICER’S REPORT
PART-I : MOCK POLL CERTIFICATE
Name of election :………………………………………………………….. (to be pre-printed)
No. and Name of AC/AS : ………………………………………………. (to be pre-printed)
No. and Name of PC : …………………………………………………. (to be pre-printed)
Poling Station No. : ……………………………………..
(a) Conduct of mock poll and verification of mock poll data
SL. Name of Number of Number of votes Number of Result displayed Signature of Polling
votes cast displayed in CU VVPAT printed in CU & Printed agents with party
NO. Candidate during the on checking the Paper slips Paper Slips count abbreviation/Indepe
against tallied with each ndent
mock poll result other (Yes/No)
Candidates
1 AAAAAAAAAA 4 4 4 YES
2 BBBBBBBBB 6 6 6 YES XXXXXX
3 CCCCCCCCCCC 10 10 10 YES
4 DDDDDDDDDDDD 8 8 8 YES XXXXXX
5 EEEEEEEEE 2 2 2 YES XXXXXXX
6 FFFFFFFFFFFFFF 5 5 5 YES
7 GGGGGGGGGGGGG 6 6 6 YES
8 HHHHHH 3 3 3 YES XXXXXXXX
9 IIIIIIIIIIIIIIIIIII 4 4 4 YES
YES
YES XXXXXXX
NOTA 2 2 2 YES
TOTAL 50 50 50 YES
(b) ‘CLEAR’ button on the Control Unit has been pressed to clear mock poll data (Yes/No) if yes, then
write the above sentence in ink
…………………………………………………………………………………………………
(c) All paper slips taken out from VVPAT after mock poll (Yes/No)
(d) Empty VVPAT shown to all Polling Agents (Yes/No)
(e) Before actual poll ensure that no printed paper slip is in VVPAT Drop Box and shown to Polling
Agents (Yes/No)
(f) ‘TOTAL’ button on the Control Unit has been pressed to show total vote ‘O’ to polling agent
(Yes/No)
(g) Mock poll VVPAT slips stamped with ‘MOCK POLL SLIP’ and sealed in black envelope and then
sealed with Pink Paper Slip (Yes/No)
(h) Following witness Mock Poll and certify that mock votes tallied and that the mock votes erased
from CU after mock poll

S.No. Name of the Name of Party Name of Signature of

Polling Agent Candidate Polling Agent
(i) Time display on the Control Unit is …………………….minutes more / less than Indian standard
Time(IST), if any
(j) Signature of Micro-Observer (if posted at the polling station)

Name and signature of the Presiding Officer

(1) It is, hereby, certify that before commencement of actual poll, ‘TOTAL, button of the Control
Unit has been pressed in the presence of all polling officials to ensure that ‘ total Vote is
0’ Tick the appropriate observation :
Control Unit shows Total vote : 0
OR
Control Unit shows total vote more than ‘0’ (means mock poll votes not cleared),
hence clear the mock poll data
signature of the Presiding Officer
Following witness the above process and certify that mock votes erased from the Control Unit
and mock poll VVPAT slips removed from the VVPAT before start of actual poll ::

S.No. Name of Polling officer Signature

 PRESIDING OFFICER’S REPORT
(Chapter-4, Para 4.6)
PART-II: POWER PACK REPLACEMENT IN CU
(TO BE FILLED DURING MOCK POLL, POLL & AFTER COMPLETION OF POLL DEPENDING ON CASE/SITUATION
Name of election :………………………………………………………….. (to be pre-printed)
No. and Name of AC/AS : ………………………………………………. (to be pre-printed)
No. and Name of PC : …………………………………………………. (to be pre-printed)
Poling Station No. : ……………………………………..
(a) Details of replacement of Power Pack of the Control Unit during mock poll/ actual poll (strike out whith
one is not applicable)
i. Unique ID of Control Unit : ………………………………
ii. Reason for replacement of Power Pack of the Control Unit : ……………………
iii. Unique ID of old address tag that was cut by the Presiding Officer to replace the Power Pack of
the Control Unit ……………………….
(b) Following Polling Agents witness the replacement of power pack from the Control Unit :
S.No. Name of Polling Agent Name of Party Name of Candidate Signature of Polling
Agent
1
2

Repeat the above information in same format, if multiple replacements happen.

Signature of Presiding Officer

Signature of Sector Officer

 PRESIDING OFFICER’S REPORT
(Chapter-1, Para 1.13)
PART-III: PRESSING OF CLOSE BUTTON AFTER COMPLETION OF POLL

Name of election :………………………………………………………….. (to be pre-printed)

No. and Name of AC/AS : ………………………………………………. (to be pre-printed)
No. and Name of PC : …………………………………………………. (to be pre-printed)
Date of Poll : …………………………..
Poling Station No. : ……………………………………..
It is certified that I have pressed the “Close Button” of the Control Unit at the end of pll in the presence of the
following

S.No. Name & Designation of the Polling Officer Signature

1

S.No. Name of Polling Agent Name of Party Name of Candidate Signature of Polling Agent

1
2
3
4

Signature of Presiding Officer

DVR
 PRESIDING OFFICER’S REPORT
(Chapter-1, Para 1.14)
PART-IV: EVM / VVPAT REPLACEMENT (TO BE FILLED DURING MOCK POLL, POLL , IF THERE IS ANY REPLACEMENT)
Name of election :………………………………………………………….. (to be pre-printed)
No. and Name of AC/AS : ………………………………………………. (to be pre-printed)
No. and Name of PC : …………………………………………………. (to be pre-printed)
Poling Station No. : ……………………………………..
(a) Details of Electronic Voting Machine and VVPAT used-
{BU- Balloting Unit, CU-control Unit and VVPAT- Voter Verifiable Paper Audit Trail}
S.No Particulars BU CU VVPAT Signature of Sector
Officers in case of
replacement

1 Unique ID of units given at the time of dispersal

(a) Tick(Y) which one found non-functional during mock poll

(b) Reason for nonfunctioning (Mention error/code noticed in

CU)

3 Unique ID of unit(s) given as replacement during mock poll

b) Following Polling Agents witness the replacement process

S.No. Name of Polling Agent Name of Party/ Name of Candidate Signature of Polling Agent
Independent

1
2
3
4

Signature of Presiding Officer

 PRESIDING OFFICER’S REPORT
(Chapter-1, Para 1.14)
PART-V: EVM / VVPAT REPLACEMENT
(TO BE FILLED DURING POLL, & AFTER COMPLETION OF POLL DEPENDING ON CASE/ SITUATION)
Name of election :………………………………………………………….. (to be pre-printed)
No. and Name of AC/AS : ………………………………………………. (to be pre-printed)
No. and Name of PC : …………………………………………………. (to be pre-printed)
Poling Station No. : ……………………………………..
(a) Replacdement of EVM and VVPAT during actual poll process
S.No Particulars BU CU VVPAT

1 (a) Unique ID of units found non-functional during actual poll

(b) Time of occurrence of defects

(c) No. of votes recorded in the Control Unit by the time the unit(s) got nonfunctional

(d) Reason for non-functioning tarnation error/code noticed in CU

(e) Beep Sound is heard

(f) Unique ID of new unit(s) provided as replacement

(g) Time of re-starting poll

2 Remarks, if any
b) Following Polling Agents witness the replacement process during actual poll
S.No. Name of Polling Agent Name of Party/ Name of Candidate Signature of Polling Agent
Independent

1
2
3
4

Signature of Presiding Officer

 DECLARATION BY THE PRESIDING OFFICER
PART – I
Declaration by the Presiding Officer before the commencement of the poll
Election from ………………………………………………………Parliamentary/Assembly Constituency
Serial No. and Name of Polling Station ………………………….
Date of Poll ……………………..
I hereby declare:
(1) That I have demonstrated to the polling agents and other persons present—
(a) By holding a mock poll that the voting machine is in perfect working order and that no vote is already recorded therein; After mock poll we have cleared the mock poll data from
EVM(CU), and removed the print paper slips from VVPAT drop box
(b) That the marked copy of the electoral roll to be used during the poll does not contain any marks other than those used for issuing postal ballot papers and election duty
certificates;
(c) That the Register of Voters (Form 17A) to be used during the poll does not contain any entry in respect of any elector;
(2) That I have affixed my own signature on the paper scal(s) used for sccuring the result section of Control Unit of the voting machine and obtained thereon the signatures of such of the polling
agents as are present and desirous of affixing the same.
(3) That I have written the serial number of the Control Unit on the special address tag, and I have affixed my signature on the back side of the special address tag and also obtained thereon the
signatures of such of the candidates/ polling agents as are present and desirous of affixing their signature
(4) That I have affixed my signature on the modified new green paper seal and also obtained thereon the signatures of such candidates/polling agents as are present and desirous of affixing their
signature.
(5) That I have read out the pre-printed serial number of the special address tag and asked the candidates/polling agents present, to note down the serial number.

Signature of Presiding Officer

Signature of Polling agents:

1. …..............……….(of candidate …………………………..) 2. ……………(of candidate ………………)
3. ………………………….(of candidate …………………………..) 4. ……………(of candidate ………………)
5. ………………………….(of candidate …………………………..) 6. ……………(of candidate ………………)
7. ………………………….(of candidate …………………………..) 8. ……………(of candidate ………………)

The following Polling agent(s) declined to affix his/her/their signature(s), on this declaration:
1. ………………………….(of candidate …………………………………) 2. ……………(of candidate ………………)
3. ………………………….(of candidate …………………………..) 4. ……………(of candidate ………………)

Date : Signature of the Presiding Officer

 DECLARATION BY THE PRESIDING OFFICER

PART-II :: DECLARATION BY THE PRESIDING OFFICER AT THE TIME

OF USE OF SUBSEQUENT VOING MACHINE, IF ANY

PART-III :: DECLARATION AT THE END OF POLL

(తప్ప నిసరిగా పూరి ి చేయాలి)

PART-IV :: DECLARATION AFTER THE SEALING OF THE VOTING

MACHINE (తప్ప నిసరిగా పూరి ి చేయాలి)

DVR
 ANNEXURE-11
(Chapter – 2, Para 2.12)
POLLING AGENTS/ RELIEVING AGENTS MOVEMENT SHEET

S.No No. and Name No. and Name of Name of Name of Polling Time Signature Time Signature
. of Parliamentary Name of Candidate Political Agents/Relieving of of Exit
Constituency Assembly Party Agents Entry
segment

1
2
3
4
5
6
7

Signature of the Presiding Officer

 ANNEXURE-12
Specimen of Entry Pass
(To be issued by Presiding Officer on poll day)

Sl. No.
ENTRY PASS
AC No. & Name :
Polling Station No. & Name :
Name of Candidate :
Name of Polling Agent :
Name of Relief Agents, if any :

Signature of the Presiding Officer

 ANNEXURE-13
Account of Entry passes issued to Polling Agents
1. Number and Name of Assembly Constituency :
2. Number and Name of Polling station :
3. Total Number of Contesting candidates :
4. Number of entry passes received with poll material :
5. Details of entry passes issued to Polling Agents :

Name of Candidate Whether entry passes Signature of the Polling

issued Agent/Relief Polling Agent

6. Unused Entry Passes :

Signature of the Presiding Officer

 ANNEXURE-14
(Chapter – 4, Para 4.3.1)

FORM OF DECLARATION BY ELECTOR WHOSE NAME IS IN

ABSENTEE/SHIFTED/DEAD LIST (ASD List)
I hereby solemnly declare and affirm that I am the same person whose name
appears at Serial No …………… of Part No ……… of the existing electoral roll of the
……………….. Constituency which was prepared/ revised with respect of first date of
………….. As qualifying date. I am aware that impersonation at elections is an electoral
offence under the section 171D of the Indian Penal Code.
………………………………….
Signature/Thumb impression of the Elector
Name : ……………………………..
Certified that the above declaration was made and subscribed by the elector above
named before me.
…………………………………
Signature of the Presiding Officer
…………………………………
Number and name of Polling Station
Date : 13-05-2024
 ANNEXURE-15
(Chapter – 5, Para 5.8.2)

FORM OF DECLARATION BY ELECTOR ABOUT AGE

I hereby solemnly declare and affirm that my age was more than 18 years on the first
date of …………….. i.e. the qualifying date with reference to which the existing electoral roll of the
constituency was prepared/revised
I am aware of the penal provisions of section 31 of the Representation of the People
Act, 1950. for making any false declaration in connection with the inclusion of any name in the
electoral roll or the preparation, revision or correction of the electoral roll.
Signature/Thumb impression of the Elector ………………………………
Father/Mother/Husband’s Name : ……………………………..
Part number of electoral Roll ……………………………….
Serial number of Elector ………………………………….
Date 13-05-2024

Certified that the above declaration was made and subscribed by the elector above
named before me.
Signature of the Presiding Officer …………………………………
Number and name of Polling Station …………………………..
Date : 13-05-2024
 ANNEXURE-16
(Chapter – 5, Para 5.8.3)
LIST RELATED TO UNDER – AGED ELECTORS
Election to ………………………………..(name of Constituency)
No. and Name of Polling Station ………………
Part – I
LIST OF VOTERS FROM WHOM DECLARATION AS TO THEIR AGE HAVE BEEN OBTAINED
Sl. No. Name of elector Part No. and serial No. in Age as entered in Age as assessed by
electoral roll electoral roll the Presiding Officer

Part – II
LIST OF ELECTORS WHO HAVE REFUSED TO MAKE DECLARATIONS AS TO THEIR AGE
Sl. No. Name of elector Part No. and serial No. in Age as entered in Age as assessed by
electoral roll electoral roll the Presiding Officer

Date : 13-05-2024 Signature of the Presiding Officer

 ANNEXURE-17
(Chapter – 5, Para 5.9.2)
DECLARATION UNDER RULE 49MA
General Election to ………………………………..
Sl. No. and Name of Parliamentary/Assembly Constituency ………………
No. and Name of Polling Station …………………………….
FORM OF DECLARATION BY ELECTOR TO BE FILLED BEFORE CASTING A TEST VOTE UNDER RULE
49MA OF CONDUCT OF ELECTIONS RULES, 1961
1. I hereby solemnly declare and affirm under sub rule (1) of Rule 49MA of the Conduct of Elections Rules 1961 that the paper slip generated
by the printer attached to the Balloting Unit has shown the name and/or symbol of a candidate other than the candidate for whom I
voted by pressing the concerned blue button against the name and symbol of the candidate of my choice on the Balloting Unit. I am ready
to cast a test vote again to show that the allegation made by me is true and bonafide.
2. I am aware of the penal provisions of Section 177 of the IPC that I shall be liable to be punished with imprisonment for a term which may
extend to six months, or with fine which may exend to one thousand rupees, or with both, if the declaration given by me in para I above
to the Presiding Officer appointed under Section 26 of the RP Act, 1951 is found to be incorrect.

Signature/Thumb impression of the Elector

Name of the Elector …………………………………
Father/Mother/Husband’s Name ………………………………………
Part No. of electoral roll …………………………………
Sl. No. of elector in that Part ……………………………..
Sl. No. in Register of Voters(Form 17A) ……………………….
Dated : 13-05-2024
Certified that the above declaration was made and subscribed by the elector above named before me.

Signature of the Presiding Officer

Dated : 13-05-2024

DVR
 FORM – 17B
(Sec Rule 49P)
List of Tendered Votes
Election to the House of the People/Legistrative assembly of the State ………………………………..
From …………………Constituency.
No. and Name of Polling Station ………………
Part No. of Electoral Roll …………..

Sl. Name of Elector Sl. No. of Sl. No. in Register of voters Signature/Thum
No. Elector in (Form 17A) of persons who b impression of
electoral roll has already voted in place of elector
elector
1
 ANNEXURE-18
(Chapter –5, Para 5.2.5)

DECLARATION BY THE COMPANAION OF BLIND OR INFIRM ELECTOR

………………………….. Assembly Constituency (Comprised within …………………..
Parliamentary Constituency)
Sl. No. and Name of Polling Station ……………………………………….
I, …………………………………………. Son of …………………………………. Aged ……………..
Resident of …………………..……………..hereby declare that :
(a) I have not acted as companion of any other elector at any polling station today, the
……………………….
(b) I will keep secret the vote recorded by me on behalf of ……………………………………….

Date : 13-05-2024 Signature of Companion

____________________________________________________________________
Full address to be given :

DVR
 FORM – 14A
(Sec Rule 40(2) and 40A(2))
List of Blind and Infirm Voters
Part Full Name of Full name of Address of Companion Signature/Thum
No. & Elector Companion b impression of
Sl. No. Companion
of
elector
 ANNEXURE-20
(Chapter –5, Para 5.7.4)
LETTER OF COMPLAINT TO THE S.H.O. POLICE
TO
The Station House Officer,
…………………
Subject :- Election to ………………… Assembly Constituency comprised within …………………… Parliamentary
Constituency. Impersonation at Polling Station ………………………………(number and name)
Date of Poll : ………………
Sir,
I am to report that Sri ……………………………. Son of Sri ………………. And resident of ……………… has
challenged the identity of the person who is being handed over to …………. . This person claimed to be ……………
whose name appears at Serial No . ………...… in Part No. ……....….. of the electoral roll of ……………………..
Constituency. He could not prove himself to be this elector. In my opinion he is an imposter. I am to request you
to take necessary action as required under section 171-F of the Indian Penal Code.
Yours faithfully,
……………………
Signature of Presiding Officer
Place ……………
Date : 13-05-2024
Copy forwarded to :
The Returning Officer for ………………………………. Assembly Constituency
The Returning Officer for …………………………….. Parliamentary Constituency
_________________________________________________________________________________________
RECEIPT
The above letter and the person referred to therein were handed over to me at ……………(hour) on
……………..(date) by the Presiding Officer.
Here insert ex-officio designation of the concerned Returning Officer

Signature
 ANNEXURE’S

1. LIST OF POLLING MATERIALS FOR A POLLING STATION (ANNEXURE -3) (Page:96,97,98)

2. CERTIFICATE REGARDING THE ROLL TO BE USED AS MARKED COPY (ANNEXURE -4) (Page:99)
3. PRESIDING OFFICER’S REPORTS (ANNEXURE -5) (AC-1,PC-1)
PART -1 : MOCK POLL CERTIFICATE (Page:100,101)
PART -2 : POWER PACK REPLACEMENT IN CU (Page:102)
PART -3 : PRESSING OF CLOSE BUTTON AFTER COMPLETION OF POLL (Page:103)
PART -4 : EVM/VVPAT REPLACEMENT (Page:104)
To be filled during MOCK POLL , if there is any replacement
PART -5 : EVM/VVPAT REPLACEMENT (Page:105)
To be filled during POLL & AFTER COMPLETION of poll, depending on case/situation
4. DECLARATION BY THE PRESIDING OFFICER (ANNEXURE -6)
PART -1 : Declaration by the Presiding Officer before the commencement of the poll
(Page:106,107)
PART -2 : Declaration by the Presiding Officer at the time of use of subsequent voting
machine, if any (Page:108,109)
PART -3 : Declaration at the END OF POLL (Page:110)
PART -2 : Declaration after the SEALING OF THE VOTING MACHINE (Page:111)
5. PRESIDING OFFICER’S DIARY (ANNEXURE -7) (Page:112,113,114)
******FORM 17A
6. FORM 17C (ANNEXURE -8) (Page:115,116,117)
PART I : ACCOUNT OF VOTES RECORDED
PART II : RESULT OF COUNTING
7. MEMO FOR PRESIDING OFFICER (ANNEXURE -10) (Page:122,123)
8. POLLING AGENTS / REVIEVING AGENTS MOVEMENT SHEET
(ANNEXURE -11) (Page:124)
9. AGENTS ENTRY PASS (ANNEXURE -12) (Page:125)
10. ACCOUNT OF ENTRY PASSES ISSUED TO POLLING AGENTS (ANNEXURE -13) (Page:126)
11. FORM OF DECLARATION BY ELECTOR WHOSE NAME IS IN ASD LIST
(ANNEXURE -14) (Page:127)
12. FORM OF DECLARATION BY ELECTOR ABOUT AGE (ANNEXURE -15) (Page:128)
13. LIST RELATED TO UNDER AGED ELECTORS (ANNEXURE -16) (Page:129)
14. DECLARATION UNDER RULE 49MA (ANNEXURE -17) (Page:130)
15. DELARATION BY THE COMPANAION OF BLIND OR INFIRM ELECTOR
(ANNEXURE -18) (Page:131)
16. RECEIPT BOOK (ANNEXURE -19) (Page:132)
17. LETTER OF COMPLAINT TO THE S.H.O. POLICE (ANNEXURE -20) (Page:133)
18. RECEIPT OF RETURN OF ELECTION RECORDS AND MATERIAL AFTER POLL
(ANNEXURE -22) (Page:135,136)

DVR
 ముగింపు
➢ ప్రిసైడింగ్ ఆఫీసర్ గా ప్నిచేయడిం గర్వ కార్ణిం & ప్రప్త్యే క గౌర్విం
➢ ఓికగా మరియు వ్యే హాతమ కింగా ఉిండిండ.
➢ PSలోని అనిి రాజకీయ నాయకుల చిప్రాలను కవర్ తో కిప ఉించిండ.
➢ PS వెలుప్ల పోటీలో ఉన్ి అభ్ే ర్థుల జాబిాను అతికించిండ.
➢ VVPAT ముిందు ట్యే బ్ లైట్ వెలుతుర్థ నేర్థగా ప్డేటట్లు కాకుిండా కించిం సైడ్ క
ఉించిండ.
➢ పోలిింగ్ ఏజింట్ ల నియామకానిి వీలైన్ింత వర్కు రాప్రతిక పూరి ి చేయిండ.
➢ Mock Poll చేసేటపుప డు తప్ప నిసరిగా ప్రప్తివారిక ఓట్ల ప్డేవిదింగా 50 ఓట్లు
వేయవలెను.
➢ VVPAT,CU మరియు BU మారిి న్టయి ు త్య ప్రప్తివారిక 1 ఓట్ల మాప్రతమే వేసి వారికీ
చూప్వలెను
➢ Mock Poll చేసిన్ తర్థవాత దానిలో ఉిండే votes మొతిం ి CU మరియు VVPAT లో
తప్ప నిసరిగా clear చేయవలెను.
➢ CU లో TIME కూడా తప్ప నిసరిగా ఖచిి తింగా ఉిండాలి
➢ MOCK POLL అయిన్ తర్థవాత ఆయా SLIP లను వెనుక వైపు “MOCK POLL SLIP” అని
ట
స్ ాం ిం్ వేసి BLACK కవర్ లో ఉించి AGENTS చే సింతకాలు తీసుకోవలెను .
➢ Mock poll అయిన్ తర్థవాత CUకు SEAL వేసేటపుప డు తప్ప నిసరిగా CUను SWITCH
OFF చేయవలెను. Paper seal పై ఏజింట్్ సింతకాలు తీసుకోవలెను.
తర్థవాత Cuలో Total “0” ఉన్ి దని ఏజింట్్ అిందరిక చూప్ిండ.
➢ ఎకుు వ టర్థు VVPAT, CU ను టెస్ట ాం చేయకూడదు . కార్ణిం బాటరీ అయిపోతుింి.
➢ ముిందు రోజే అనిి పేప్ర్్ serial numbers ప్రవాసి పెట్లాంకోిండ.
➢ CU పైన్ ప్రీన్ పేప్ర్ seal లో serial number కనిిించేటట్లు ఉిండాలి.
➢ ఇతర్ దేశాలనుించి ఓటర్థ వసే ి PASSPORT అడగాలి.
➢2 BUలు ఉన్ి పుప డు 1వ BU పైన్ స స్ యి ు డ్ సివ చ్ 01 గాను, 2వ BU పైన్ స
స్ యి
ు డ్
సివ చ్ 02 గాను ఉిండాలి.
➢17 C, 17A మరియు పోలైన్ ఓట్లు ఒకేలా ఉిండాలి
➢MALE క అయిత్య /, FEMALE క అయిత్య / + NUMBER క “జీరో” చుట్టాంలి మరియు
TRANSGENDER వసే ి STAR కూడా గురిించాలి.
ి
➢పోలిింగ్ సే ాం న్ లో ఎట్లవింటి తగవు జరిగన్ వీడయో ప్రగాఫర్ ఉింటే వారిచే రికార్ ్
స్ న
చేయిించాలి. అవసర్మైత్య S O కు తెలప్వలెను.
➢ఏజింట్ Chellenge చేసే ి చలనా ు కటిింాం చుకోవాలి.
➢VISIT SHEET ఎప్ప టికపుప డు రాస్తి ఉిండవలెను.
➢పోలిింగ్ రోజు రాప్రతి 12 గింటల వర్కు పోలిింగ్ జర్థగుతూ ఉింటే తప్ప నిసరిగా
VVPAT ,BU మరియు CU మార్ి వలెను. PO డైరీ లో కూడా ప్రవాయవలెను
After Polling తర్థవాత “CLOSE” బటన్ తప్ప నిసరిగా నొకాు లి
“Queue” ఉింటే Slips ఇచిి information S.O. కు తెలుప్వలేను
➢Companaion/Under Age/ASD List/ Proxy ఓటర్ వచిి న్పుప డు జాప్రగతప్ ి డ , వారిచే
సింతకిం చేయిించుకోవలెను.
➢MOCK POLL చకు గా జరిిన్టయి ు త్య ½ work కింప్లట్
ు అయిన్ట్లు
➢1st ఒక గింట లోపు చాలా జాప్రగతగా
ి ఉిండాలి. దింగ ఓట్లు ప్డే ఆటు ర్ిం ఎకుు వ
ఉింట్లింి.
➢Agents క ముిందే అనిి వినయాలు తెలియజేయాలి
➢Declaration లేకుిండా companion ని allow చేయకూడదు. report రాయాలి.
➢(ANNEXURE 18 FORM-14A)
➢ASD/ TEST VOTE/ AGE/ CHALLENGE report రాయాలి.
➢కళ్ళు బాగా కనిిసుినాి కనిిించలేదు అింట్టర్థ. వారిని టెస్ట ాం చేయాలి.
➢AGENTS మేము ఏమి అనుకోము అింట్య ఉింట్టర్థ.

DVR
 ఏజింట్లు సింతకాలు చేయవలసిన్ ఫారాలు

1. PRESIDING OFFICER’S REPORT

a) Mock Poll certificate (Page No: 100,101)
b) Power Pack Replacement in CU (page No: 102)
c) Pressing of Close button after completion of Poll (page No: 103) and OPOs
d) EVM/VVPAT Replacement
1. To be filled during Mock Poll, if there is any Replacement (page No: 104)
2. To be filled during Poll &After completion of Poll depending on
case/situation (page No: 105)
2. Declaration by the Presiding Officer before start of poll(page No: 106 & 107) ANNEXURE - 6
3. Declaration by the Presiding Officer at the time of use of subsequent voting machine, if any
(page No: 108 & 109)
4. Declaration at the End of Poll (page No: 110)
5. Declaration after the Sealing of the Voting Machine (page No: 111)
6. FORM 17C (ANNEXURE – 8) Page no. 115,116
7. Mock Poll slips (black cover పైన)(pink paper seal పైన )
8. Special tags పైన
9. Green paper seal పైన
10. Appointment of Polling Agent (Form-10)
11. Address tags పైన
12. Movement register during every entry/exit of polling station
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SPSR NELLORE District
ఆతమ కూరు అసంబ్లు
న్నయోజకవర గం
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General Elections 2024

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