Note :Fields marked with asterisk (*) are mandatory

Form 001

*
*

I request that a Duplicate Photo identity Card be issued to me as my original card is lost /destroyed /mutilated due to correction in my elector's details or due to change of address I want to get a fresh card with my new address. I am returning my EPIC to you along with the fee for issue of duplicate EPIC. My name is included in the electoral roll of the above constituency. Particulars in support of my claim for issue of duplicate EPIC are given below.

*
*
*
*
*
*
*
*
*
*
*


Reason for applying for a Duplicate Card


*
*
Captcha