Application Form-1 - Indira Gandhi Pyari Behna Sukh-Samman Nidhi Yojna

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çIk= ¼1½

fgekpy izns”k ljdkj


lkekftd U;k; ,ao vf/kdkfjrk foHkkx] fg0ç0

Øe la[;k---------------------------------------------
Ikathdj.k frfFk------------------------------------

baafnjk xka/kh I;kjh cguk lq[k&lEeku fuf/k ;kstuk

1- vkosfndk dk uke%---------------------------------------------------------------------------------------------------------------------------

2- firk dk uke%---------------------------------------------------------------ekrk dk uke--------------------------------------------


vkosfndk dk+ QksVks
ifr dk uke%-------------------------------------------------------------------------------------------

3- ;fn firk@ ifr@ekrk thfor ugh ga S rks laj{kd dk uke o lECkU/k

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

4- LFkkbZ irk%&xkao----------------------------------------------------------------------------------------okMZ ua0--------------------------------------------------

iapk;r-------------------------------------------------------Mkd?kj---------------------------------------------rglhy------------------------------------------------------

ftyk-------------------------------------------------------------------fiu dksM----------------------------------------

5- nwjHkk"k@eksckbZy la[;k%------------------------------------------------------------------------------------------------------------------------------------------------------

6- tUefrfFk%&¼vadksa es½a %-----------------------------------------------------'kCnksa esa-----------------------------------------------------------------------------------------

7- Js.kh%& vuq0 tkfr@vuq0 t0 tkfr@v0 fi0 oxZ @vU;

8- D;k vkosfndk vYila[;d leqnk; ls lEcU/k j[krh gS\ gka @ugha

9- D;k ch0 ih0 ,y0 ifjokj ls lEcfU/kr gS%&--------------------------------------------------------------------------------------------------------------

10- ;fn gka] rks ifjokj dh ch0 ih0 ,y0 la[;k losZ{k.k o"kZ lfgr%--------------------------------------------------------------------------

11- vkosfndk dk vk/kkj dkMZ uEcj%------------------------------------------------------------------------------------------------------------------------------------


12- vkosfndk ds ifjokj dk jk”ku dkMZ uEcj%-------------------------------------------------------------------------------------------------------------------

13- D;k vkosfndk ds ifjokj ls fuEu +Jsf.k;ksa ds lnL; gSa \


dsUnz@jkT; ljdkj ds deZpkjh@iSa'kuj] vuqcU/k@vkmVlkslZ@nSfud
osruHkksxh@ va'kdkfyd bR;kfn oxZ ds deZpkjh] lsokjr@HkwriwoZ lSfud
o lSfud fo/kok;s]a ekuns; izkIr vkaxuokMh+ dk;ZdrkZ@lgkf;dk@
vk'kkodZj@feM Ms ehyodZj@eYVh VkLd odZj] lkekftd lqj{kk iSa'ku
ykHkkFkhZ] iapk;r jkt laLFkkvksa @'kgjh LFkkuh; fudk;ksa ds deZpkjh] gk¡@ugha
dsUnz@jkT; ljdkj ds vUrxZr fofHkUu lkoZtfud
midze@cksMZ@dkamfly@,tSalh esa dk;Zjr@iSa'kuHkksxh] oLrq ,oa lsok
dj gsrq iathd`r O;fDr rFkk vk;dj nkrk bR;kfnA

14- vkosfndk ds uke cSad@Mkd?kj esa cpr [kkrs dk fooj.k %


¼d½ cSad@Mkd?kj dk uke tgka [kkrk gS%
¼[k½ [kkrk la[;k%
¼x½ vkbZ- ,Q- ,l- lh- dksM%

eSa Øe la[;k 1 ls 14 rd nh xbZ lwpuk dks lR;kfir djrh g¡wA bl lwpuk esa dksbZ Hkh tkudkjh
feF;kRed ;k Hkzked ugha gSaA

izkFkhZ ds gLrk{kj@vaxwBs dk fu'kku


¼iSM dh L;kgh ds lkFk½
lR;kiu fjiksVZ

izekf.kr fd;k tkrk gS fd dqekjh@Jherh---------------------------------------------------------------------------------------

lqiq=h@iRuh----------------------------------------------------------------xkao--------------------------------------------okMZ ua0---------------------------------------------

Mkd?kj-----------------------------------------------iapk;r ----------------------------------------------------------------- rglhy-----------------------------------------

ftyk-------------------------------------------------------------fiudksM--------------------------------------fgekpyizn's k dh LFkk;h fuoklh gSA

vkosfndk }kjk izLrqr izek.k i=ksa@rF;ks@


a nLrkostksa dh tkap eaSus Lo;a dh gS rFkk blds n`f"Vxr

vkosfndk bafnjk xka/kh I;kjh cguk lq[k&lEeku fuf/k ;kstuk ds vUrXkZr fu/kZkfjr jkf'k izkIr djus gsrq

¼ ½ ik=@vik= gS rnkuqlkj vkosfndk ds izkFkZuk i= dks ¼ ½ Lohd`r@jn~n djus

dh flQkfj'k dh tkrhgSA

rglhy dY;k.k vf/kdkjh

rglhy%

ftyk%

uksV%&vkosfndk vius vkosnu i= ds lkFk fuEufyf[kr izek.k i= layXu djs%&

1- fgekpyh cksukQkbZM@ewy fuoklh izek.ki=A


2- vk;q izek.k i=A
3- cSd@Mkd?kj [kkrk la[;k dh Nk;kizfrA
4- vk/kkj dkMZ dh Nk;kizfrA
5- ifjokj jftLVj ¼xzkeh.k {ks=½ ;k jk”ku dkMZ ¼“kgjh {ks=½ dh Nk;kizfrA
6- ckS) fHk{kq.kh ds fy;s iapk;r vFkok ckS) eB dh eq[; pkseks }kjk tkjh izek.k i=A

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