I ____ son of do hereby solemnly affirm and declare as under :-
1. That I am the Citizen of India.
2. That I am __ years old.
3. That I have been residing at above said address for the last __ years.
4. That my name is not recorded /entered in Voter List anywhere in India. And I have not applied to enlist my name anywhere in India.
5. That I am fully abide with the provisions of section __ of ____.
6. That my name may be recorded/entered in Voter List and the Voter Identity card of Election Office, may be issued to me.
Verified that the contents of my above said affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.