RUPASHREE PRAKALPA moral aerst Deptt. of Women & Child Development and Social Welfare ‘Government of West Bengal 8 Pre Rent at oar tt ee Application Form SAE To be filed up in blockletersin English only “OST Reece Re FATS TH For Offce Use Only [Application No Received on Received by Signature Bloc -Mancipality/Corporation Applicant's Details Sicervaitis cet Name Must be spelt exactly ast is your bank account) a (ame wraBCB oa wT Ow re Date of bith (woew eee Proposed date of mariage (watts Feces) Mothers name (es) reesei es Ee roe Fathers name (oo) (Current Address (28 Be) House No. (a= Permanent Address (4 ar) Road\Street (emt =) Roadi/Street ate =) Police Station (&=) Police tation (=) Post Ofce (oS) Post office (en a) GP. Ward (2x swe / 26) CGP. Vad ae rr ts) Block/SO-Mtuniepaity SD-Munepal Corporation ie (ae / sens) Block. Municipal (9 / eg ARF ity, SO-Munllpa Corporation ste 3 Diane =) State m=) Distr (a=) State a) Pin code (a os Pincoge (a or)Contact Mobile No. (crsterer aratto 5%) Account No, (= 5 Please note that you wil receive sms about your application Bank this number (2 ate sto ee ce er ee ot) Details (xrewa fee) Your account should be able to receive Rs. 25,000/-at atime cera are tRBCE cor eee a el TE Ce) TFS Code (w.ae.4%, cre) ICRI, (e489. Pes. 3) Sank Name (D6 =) Branch Name (=) Branch Address (ee =) of record only ) (Tick as applicable) (west eae 5 (Vf) LJ saduate reste o (areceren) Caucaton ee Or cone ren Oe, Oe OO ees) Ose O&s of OR, we Oe Oey Oe | [Fie Oi [Lseheauie he ros csnty ome Sw Dig Oey Name in fll 5) Groom's Details (tara fa") Date of Bith (ea wf) Mathers Name (ea) Colowed Passo Se Photograph of Groom oa ea 7 Father's Name (7a 8) Current Ada House No, (ase (a4 Bata) nent Address (Xt) House No, (ae RoadiSteet ARR) RoadiSteet ATTA) Post Ofice (20m Pon OficeGP Ward (re ere ots) GP. Ward (me es / ee) BlockSb-Muricipaly S-Municipal Corporation| Bloc/SD-unipaiy, SD-Munipal Corporation i Fw -ROAIRIS Jace) (a eee ROBES / ee) Dist (oe) State (rm) Distt (ome State frm Pincode (9m 57s) Pincode (Pa a) Declarations and Documents submitted (caret ¢ "if Fa S1e1E) I declare that: (af cet =a ce) sed marriage is my first marriage (att aftaeet x: sfc Fare sex Fee) 2. My amily income is not more than Rs. 1.50 lakhs per annum (stirs “ee sien we 3.20 wets c=) and the pr 3. Lamaresident of West Bengal (ue. was born in West Bengal ["]/ i have lived in West Bengal for thelast 5 years 1 /my parents are permanent residents of West Bengal [_] (7 the correct box) ea xn ore (et Poneman eat [] ote ea es Poon re at [] fara Ste-ater-afostew ofroxaco eit sifen[_]) (ofan area 7 fie) 4. Lamabove 18 years ole (= <1 > awze4 Sek) [Submit any one ofthe following (ck cers «eB =f 951 Fy] a (ee tenet) Qo (cen are: So cere as) Qo come ar) a ‘School Soe preaficrn srefiS arg) (Seite eo seo CODDECE EEC 5. thaveana account for which Lam the sole account holder (a Frm sm ef om eS 1 Page of Bank Account that shows Account Holder's Name, Account No and bank details (ero ea cI TT CSTR AT, MOF HE, TORE TR, FRAT, aT wo. ee TT we 6. Proof of proposed marriage (*rafte feaIcea etx) [Submit any of one the following (x cerns ari =f erat fi) 7 Marriage invitation card 1 Marriage Registration Notice seit decartion (ere fogene 6) (Rare steer we) 7. My prospective groom is above 21 years old [Submit any of one the following (cars af =f wa a)} (ra ae 3 a ae win Wat ess eater NT ee) [tian certieate [7] voterto care [I] AADHAAR Care [-] PANCard [-] Gove Recognized [] Machyamik Admit ard (exer) cae are 6) — (8) (3516) — School Leaving Ceriiate rar =rehs FE) (wees ome pare) ny of the above inform: ion is found to be false (Sere Cereal Gey BH Sats wT AR ATT) Date (=i) Signature of Applicatant (areata 32)RUPASHREE PRAKALPA Dept of Women & Child Development &Social Welfare Government of West Bengal Enquity & Sanction Form FOR OFFICE USE ONLY Name of Applicant ‘eplation No Date Received guy Date Place ofEnguley/ GP. Wore Block Municpaliy/ Municipal Corp. Dis With regard tothe above mentioned aplicant, we have examinedher application form, the documents submited with and made detailed enauites to very the clin ofthe applicant During enguiy the fllowing facts have been estbl shed 1 [The apptcantis un-maried True | Fatee [5 Shei resident of West Bengal Tue | Fate 2 [The proposed mariage wher fist mariage | True | Fale | @ Hermarrage eto be held on orsbautthe | True | False 3 [She has attained the age of T8yeare True [Fale ]__#atementoned inher aplication [Her family income is net mare than Ri 150 aks per year tue | Fale Remarks Recommendedforsancion | Yes | Ne Witnesses Name & Adress Contact Ne. and Signature a Equity offcer EnguieyOffcer2 Name Designation Signature & Seal ate Order sanctioned Rejected ate "Name of Sanctioning Officer Pace Signature & SealRUPASHREE PRAKALPA Dept of Women & Child Development &social Welfare ‘Government of West Bengal Acknowledgement of Receipt of Application SIMA (To be filed up by office personnel and handed over tothe applicant by the receiving office) cere eR RRS a one RATATAT eB A OTR) Application No. received on. Serre a see oR From ce To: of (Name and address ofthe Applicant) corer, te © Thereby acknowledge receipt of your application cited, (me APE Siena hye em) Service be provided at least 5 days before the dae of mariage mentionedin your apliaton (ero ace Be Feet es we fee crate) on wwe, © Thefellowing defects inthe application may be ec ed, urgent: Specty defects any) meme pret ae meen cre (ee ras ra w Phe: Yours fehl eres Dates Designates Ofcer/Authorized Ofcer ovis eee om ASSome days after you submit your application, government officers will ist your locality to make an enquiry about the information you have given in the application form. If the information you have provided is found to be correct in all respects, and the goverment approves of your application, you can expect to receive the Rupashree money before your marriage date. The money will bbe ent by the government directly to your bank account. Please make sure that your bank account is ‘alive’ bank accounts that are not used atleast once every few ‘months become inoperative. If your bank account i inoperative, the government will nt be abe to transfer the money to your bank account. ‘apne Srcenaner ear croRTe FOE ake a TRS AMET core a SCH URE SCRA SIRT Se OMT MOTE, PTET AT | cst cron war of oe fae Die eon a aR TOE ICN Re MrT ER, TH TECH TOT Reus en aa Ble et ce cH PS era el we aN eM I STSIBAE mex Hee eprint wt Re TS eee, FoR ATH A STIS ETE A a ew ATTA eae Haig B aTeTET Bet tbICe eT A You must register your marriage! ‘Along with the rites and rituals that mark your mariage, you should also register your marriage. Marriage registration gives you a legal document which contains both your names, the date, place and time of your mariage, Armatriage certificate wil be requited for any steps that you wil take together as a marred couple such as: + Legal protection and inheritance rights ‘+ Social and financial protection and pension claim + Toapply for passport, vis, ration card, voter card, Aadhaar Card Every locality has Mariage Registration Officers recognized by the Government of West Bengal. Contact one Immediately and secure your future. anna area Fears arene afters Fer RfefS aah area are were Rare are ser) Bae ay Sse STE aA SO CE EIS TOT ESCA Any, faatcee rey, SINT aIcEe PRI CRT ATT ere Homie ere enCa EH HoT we A, + sR yom ox Bustos + amis 6 edtriee are + sve, fm, ca 6, cae 4, eres 00 coerce ofwes oars was Fee agers eRe eS TH | ree ee Ang a wa Or era IE wre CATR 4