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    4 views2 pages

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    4 views2 pages

    Download

    Uploaded by

    Animation Jack

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    of 2

    Applicant's Basic Information

    Salutation First Name Middle Name Last Name


    Mr. AMARNATH NA MAJI
    Date of Birth Age Gender Date of Application
    30-APRIL-2000 23 Male 21-DECEMBER-2023
    Mobile No E-mail Aadhaar Card No
    8617099700 [email protected] 216970546459

    Permanent Address of Applicant

    Country State District Sub-division


    India West Bengal Paschim Bardhaman Asansol
    Block/Municipality/Municipal Block/Municipality/Municipal
    Rural or Urban Village or Ward
    Corporation Corporation Name
    U 13
    MC Asansol (Municipal Corp)
    Police Station Post Office Address Line 1 Address Line 2

    .0
    Asansol North Nischinta BO t2Nischinta ,Pal para NA
    Pin Code
    713373
    ic
    Present Address of Applicant

    Same Address As Country State District


    tr

    permanentAddrApplicant India West Bengal Paschim Bardhaman


    is

    Block or Municipality or Block or Municipality or


    Sub Division Rural or Urban
    Corporation Corporation Name
    Asansol U
    D

    MC Asansol (Municipal Corp)


    Village or Ward Name Police station Post Office Address Line 1
    e-

    13 Asansol North Nischinta BO Nischinta ,Pal para


    Address Line 2 PIN Code
    NA 713373

    Parent or Husband details

    Parent or Husband Salutation First Name Middle Name


    Mother Mrs. LAXMI NA
    Details of Parents Business or
    Last Name Occupation
    Service
    MAJI HOUSEWIFE
    A tea shop

    Applicant Place of Birth

    Same Address As Country State District


    permanentAddrApplicant India West Bengal Paschim Bardhaman
    Block or Municipality or Block or Municipality or
    Sub Division Rural or Urban
    Corporation Corporation Name
    Asansol U
    MC Asansol (Municipal Corp)

    Generated on : 2023-12-26T11:33:19.795

    P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
    maintained by TATA Consultancy Services Ltd.
    Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
    Village or Ward Name Police station Post Office Address Line 1
    13 Asansol North Nischinta BO Nischinta ,Pal para
    Address Line 2 PIN Code
    NA 713373

    Education Detail of Applicant

    Name of Institution Class From Class To From Year To Year

    SRIPUR HIGH V XII 2009 2017


    SCHOOL

    Particulars of stay of last 15 years

    Block
    Block or
    or Muni

    .0
    Muni cipali Villag
    Rural cipali ty or Polic Addr
    Sub e or Post Addr Hous
    Coun Distri or ty or Muni e ess PIN From To
    try State ct Divisi
    on Urba Muni cipal Ward
    Nam
    t2 Stati Offic
    e
    ess
    Line Line Code Date Date e
    Type
    n cipal Corp on 2
    e 1
    Corp orati
    orati on
    on Nam
    ic
    e
    tr

    Asan
    Pasc sol Nisc
    West him Asan Nisc 2000 2023
    Asan (Mun hinta 7133
    India Beng Bard U MC 13 sol hinta -04-3 -12-2 Own
    is

    sol icipal ,Pal 73


    al ham North BO 0 0
    Corp para
    an )
    D

    Other Details
    e-

    Applicants Details of Business Duration of Stay in West


    Native State Native District
    or service Bengal
    NA NA
    NA NA
    Whether Applicant or Parents
    Possess Any Immovable Whether Applicant Migrated
    Property Like House etc. in Immovable Property Details from Any Other State or Reason for Application
    West Bengal or in Any Other NA Country Other
    State NA
    NA
    Other Reason for Application
    Educational purpose

    Generated on : 2023-12-26T11:33:19.874

    P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
    maintained by TATA Consultancy Services Ltd.
    Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen

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