paste the
ANNEXURE passport
TAMILNADU LEGISLATIVE ASSEMBLY ELECTION- 2026 size photo
Particulars of Departments/ Undertakings / Local Bodies Institutions
Polling Personnel Details
Sl.No Particulars
1 (a) Name of Department/ Undertaking/
Local Bodies/Institutions
(b) Code No Department
2 (a) Name of the office /Institution
(b) Office address
(c) Office Phone No. with STD code
(d) Talk name
3 Whether State Government (SG) or Central
Government (CG)
4 (a) Whether Public Sector Undertaking
(b) Whether Central or State Government PSU
5 Whether the local body *(PU/TP/MU/MC)
6 If Educational Institution, whether
a) College
b) Higher Secondary / High School
c) Middle /Elementary / Primary
d) Others (Non/Teaching Staff)
Particulars of Polling Personnel
7 a) Name of the Official (in BLOCK letters)
b) IFHRMS number
8 i) Designation
ii) Age
9 Sex (M/ F)
10 a. Level of Pay
b. Applicable cell
11 Current Basic Pay Rs.
12 Residential Details
i) Residential address
ii) Nearest Police Station to residence
iii) Residence Phone No.
iv) Mobile Phone No.
v) Taluk / District
13 No. & Name of the Assembly
Constituency
i) of native place AC
ii) of place of residence AC
iii) of office location AC
14 Electoral details of Polling Personnel
(a) EPIC Number (Voter ID No)
(b) No. and Name of the Assembly
Constituency
(c) Part No. in which enrolled
(d) SL.No. in which enrolled
Whether the official officiated in previous
15 General Elections or Assembly Election
(Y/N). If yes furnish details (2021/2024) etc.
16 Whether the official has previous experience
in handling EVM /VVPATs(Y/N)
17 Whether the official has been disqualified
or punished or reprimanded or transferred
out by the ECI (Y/N)
18 Whether of the official under the PwD
category (Y/N) If yes, details of disability
with percentage
19 Whether the officials is working as a BLO
(Y/N) If yes, mention the Assembly and
Part No.
.
Signature of the Offical
