Nomination Form




State*
*
CANDIDATE DETAILS
Name*
Gender
Date of Birth
Phone (Mobile): *
Phone (Landline):
Email ID
Education Qualification
Address
Voter ID Card No.
Whether you belong to any special category General
SC
ST
OBC
1. Details of Family members:
S.no Name Relation Age Gender Occupation
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2. Have you or your family member ever been convicted for any offence or any Case/FIR’s pending. If yes please give the complete detail below.
S.no Name of the Person Case No. Detail of Section Detail of Case In which year case has been started Present Situation
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3. What strategies would you adopt to win the election? And what is your budget
4. Your Suggestions and Remarks.
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