FORM 19

[See rule 31]

APP_ID: F19-0016294

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

VENKATESWARA RAO Matta
Name (in full)....................................................................................... Male
Sex....................................

RAGESH
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

2-68
House No.................................................
Venayaka temple Street
Street/Mohalla........................................

DODDIGUNTA
Town/Village..........................................

Post Office................................................
Rangam Peta

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

28
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 10-01-1996
Date of birth..................................................................................................................................

Udp1026061
(d) EPIC number (if any).................................................................................................................

9494979576
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 Dr BR Ambedkar University 24-10-2018 02-10-2022 4
04-10-2017 05-10-2018 1
2 Aditya University
01-10-2016 01-10-2017 1
3 Sachin ringtone Samsung technology
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0016963

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

V V M LAKSHMI PRASANNA YELAMARTI
Name (in full)....................................................................................... Female
Sex....................................

SRI RAMAMURTY
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

2-10
House No.................................................
NEAR ICDS OFFICE
Street/Mohalla........................................

RANGAMPETA
Town/Village..........................................

Post Office................................................
RANGAMPETA

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

30
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 15-07-1994
Date of birth..................................................................................................................................

UDP0958506
(d) EPIC number (if any).................................................................................................................

9010978659
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 ADITYA PHARMACY COLLEGE 06-06-2019 15-10-2022 3

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0017557

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

SOMA RAJU sukkireddi
Name (in full)....................................................................................... Male
Sex....................................

SATYANARAYANA
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

6-130
House No.................................................
RANGAMPETA MAIN ROAD, NEAR MEE SEVA
Street/Mohalla........................................

RANGAMPETA
Town/Village..........................................

Post Office................................................
RANGAMPETA

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

49
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 15-03-1975
Date of birth..................................................................................................................................

UDP0783572
(d) EPIC number (if any).................................................................................................................

7995137683
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 ADITYA UNIVERSITY 30-10-2006 25-10-2024 18

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0017618

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

S RAMAKRISHNA PEPAKAYALA
Name (in full)....................................................................................... Male
Sex....................................

RAMBABU
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

3-32
House No.................................................
SUBHADRAMPETA
Street/Mohalla........................................

RANGAMPETA
Town/Village..........................................

Post Office................................................
RANGAMPETA

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

42
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 10-03-1982
Date of birth..................................................................................................................................

FXF2554194
(d) EPIC number (if any).................................................................................................................

6300596898
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 aditya university 03-11-2009 26-10-2024 15

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0017827

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

SATYANARAYANARAJU Lolabhattu
Name (in full)....................................................................................... Male
Sex....................................

FATHER
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

2-26
House No.................................................
Kapula ramalayam strret
Street/Mohalla........................................

ELAKOLANU
Town/Village..........................................

Post Office................................................
Elakolanu

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

39
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 01-04-1985
Date of birth..................................................................................................................................

(d) EPIC number (if any).................................................................................................................

8897743116
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 Aditya em school 01-06-2015 01-08-2022 7

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0017964

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

BODEYYA CHEVA
Name (in full)....................................................................................... Male
Sex....................................

KRISHNA
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

2-111
House No.................................................
chandredu
Street/Mohalla........................................

CHANDREDU
Town/Village..........................................

Post Office................................................
rangampeta

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

50
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 15-09-1974
Date of birth..................................................................................................................................

UDP1491299
(d) EPIC number (if any).................................................................................................................

Contact number- (i) Mobile.............................. (ii) Landline...........................

Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 GRC JUNIOR COLLEGE 12-06-2005 08-11-2022 17

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.

 FORM 19
[See rule 31]

APP_ID: F19-0017980

To
The Electoral Registration Officer,

................................................................
East Godavari,West Godavari (Teachers¶ Constituency.

Sir,

East Godavari,West Godavari(Teachers¶ 

I request that my name is registered in the electoral roll for the .................................................
constituency.

The particulars are: ----

VINOD KUMAR CHANNA
Name (in full)....................................................................................... Male
Sex....................................

VENKATESWARA RAO
Father¶s/Mother¶s/Husband¶s name (in full)..............................................................................
House address (Place of ordinary residence): .............................................................................

6-92/6
House No.................................................
NEAR ARYA VYSYA KALYANA MANDAPAM
Street/Mohalla........................................

VADISALERU
Town/Village..........................................

Post Office................................................
VADISALERU

RANGAMPETA
Police Station/Tehsil/Taluka/Mouza..........................................................................................

East Godavari
District...........................................

34
Age.................................................

Whether registered as an elector for any assembly constituency..................................................................

If yes, then mention the following

Anaparthy
(a) Number and name of the assembly constituency............................................................

(b) Part/Polling station No. (If known)..........................................................................................

(c) 11-06-1990
Date of birth..................................................................................................................................

UDP0388967
(d) EPIC number (if any).................................................................................................................

9550441036
Contact number- (i) Mobile.............................. (ii) Landline...........................
[email protected]
Email id (if any)...............................................

2. During the last six years i have been engaged in teaching for a total period of more than three years as
follows:--

Name of Educational Institution From (Date) To (Date) Period

1 ADITYA UNIVERSITY, SURAMPALEM 28-07-2014 30-11-2022 8

2
3
In support of the above I submit herewith ..................................................................................................
..............................................................................................................................................................................
.............................................................................................................................................................................
.............................................................................................................................................................................

3. * My name has not been included in the electoral roll for this or any other teacher¶s constituency
OR
*My name has been included in the electoral roll for the ........................................ teacher¶s constituency under
the address given below and I request that it be deleted from that roll:--------
...........................................................
...........................................................
...........................................................

4. I declare that I am a citizen of India and that all the particulars given above are true to the best of my
knowledge and belief.

Place...................

Date............ ....................................
Signature of claimant.

NOTE: - Any person who makes a statement or declaration which is false and which he either knows or believes
to be false or does not believe to be true is punishable under section 31 of the Representation of the People Act,
1950.
*Strike out the paragraph not applicable.

.................................................................... (Perforation)....................................................................
Intimation of action taken

The application in Form 19 of Shri/Shrimati/Kumari..........................................................................

Address......................................................................................................................
.............................................................has been-------
(a) Accepted and the name of Shri/Shrimati/Kumari................................................. has been registered at
Serial No.............................................. In Part No................................................

(b) Rejected for the reason.................................................................................................................

Date................................ Electoral Registration Office

(Address)......................
...................................
............................]

.................................................................... (Perforation)....................................................................

Receipt of application

Received the application in Form 19 from Shri/Shrimati/Kumari*..................................................

Address*........................................................................

Date....................................

Electoral Registration Officer

(Address)...............................
.........................]

*To be filled in by the applicant.