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FORM ID ECI-EPIC-002 Election Commission of India Application for issue of Duplicate Elector s Photo Identity Card EPIC State/Ut S-25 AC NO. Name District Campaign ID WB -2000-01 Elector s Particulars To be filled by Elector A B To Sir/ Madam I request that a Duplicate Electoral Photo Identity Card be issued to me as my original card is lost/ destroyed /mutilated* My name is included in the electoral roll for the...
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