GOVERNMENT OF ARUNACHAL PRADESH

OFFICE OF THE DEPUTY COMMISSIONER PAPUM PARE DISTRICT

ITANAGAR

FORM  II

Application form for renewal of Inner Line Pass                  

(TO BE FILLED BY THE APPLICANT)             

1. Name of Pass Holder                           ....................................................................................

2. Permamnet address in full                          

            Village                                                ......................................................................................    

            Post office                                           .......................................................................................    

            Police Station                                       ......................................................................................    

            District                                                .......................................................................................

            State                                                   .......................................................................................

  3.   Present address                                      .......................................................................................

       C/O                                                          ......................................................................................   

  4.  Nationality ( with proof )                          ........................................................................................  

  5.  Pass No.                                                 .........................................................................................

                    I have by declared that the above mentioned particulars given are true and correct to the best of my knowledge and belief.

Signature of the applicant

Recommendation for Govt. Servant : By the controlling Authority.

Recommendation for Pvt.                : Proprietor/Manager of the firm / Organisation etc.