APPLICATION FORM FOR ISSUE OF NEW RATION CARD/RENEWAL OF RATION CARD
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1. |
Name of Applicant |
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2. |
Father's Name ………………………....................................... |
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3. Present Address in full : |
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Name |
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Village/Colony |
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House Number |
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4. |
Permament Address in full |
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Name |
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Village/Colony |
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House Number |
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5. |
Inner Line pass No (In case of Non Arunachalees) |
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6. |
Occupation/Designation |
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7. |
Name of Employer/Department |
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8. |
Details of Femily Member Adult …………….. |
Minor………………………. |
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Sl.No. |
Name in Full Age Sex |
Relationship with Applicant |
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…………..……. ………. ……….. |
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2. |
…………………… ……….. ………. |
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3. |
…………………… ……….. ………. |
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4. |
…………………… ………. ………. |
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5. |
………………….. ….……. ………. |
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…………………... ………. ………. |
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…………………… ………. ..………. |
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9. |
Electrol Roll No./Census No. |
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4. |
Trading Licence No. (In Case of Business Community) |
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4. |
L.P.G. Consumer. |
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I do hereby decalare that the particulars of my family members shows above are correct to the best of my knowledge and belief I do not possess any femily Identity Card (Ration Card) in my name or in the name of above femily.
Signature of Applicant
Date