District Name District Name Main Opposing Candidate & Party

Constituency Number Constituency Number

Ticket Holder Challenger

Name
Phone Number
Age
Education
Profession and Source
of Income
NTN
Dual Nationality or any
Litigation or Bank
Default

Date of Joining PTI

Participation in PTI
Activities/PTI offices
held

Previous Election
Performances

Strengths

Weaknesses

Comments on NA/PA
Candidate Panel

Any other information

justifying review

Note: This form is to be filled by the challenger who is seeking review of the ticket award.