GOVERNMENT OF ARUNACHAL PRADESH

FORM II

APPLICATION FORM INNERLINE PASS TO ENTER IN A.P.

Part - A

( To be filled by the applicant )

1. Name of the applicant in full :

2. Father's/Husband's/Mother's Name :

3. Permanent address in full

Village :

Post office :

Police Station :

District :

State :

4. Present address C/O :

5. Nationality ( with proof ) :

6. Present occupation (also in case of  :

Govt. Servant)

7. Particular place in Papum Pare :

District intended to visit

8. Purpose of visit :

9. Proposed duration of stay in Papum :

Pare District

10. Attached two attested passport size  :

photograph

11. Hold (if any ILP issued by any :

District Authority in A.P. give details.

12. Hold (If ay business licence/Permit :

in Arunachal Pradesh give details)

            I hereby declared that, to the best of my knowledge and belief, the particulars given above are true and correct.

Date :

Name and Signature of Applicant.

Present address

Police Station

Note  :

1. Recommondation for Govt. Servent : By the controlling authority.
2. Recommondation for Pvt. : Proprietor Manager of the form/Organisation etc.