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Amina Appointment

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25 views1 page

Amina Appointment

Thnk

Uploaded by

eliashtudu820
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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AADHAAR ENROLMENT

FORM

(Aadhaar Enrolment is free &


भारतीय विशिष्ट पहचान प्राधिकरण भारत सरकार Voluntary)
Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND
SERVICES) ACT,2016 (Aadhaar Act)
Submission Date : 20-07-
Application Type : Enrolment
2024
Applicant Details Appointment Details

Resident Type: RESIDENT


Full Name: AMINA NESA
Date Of 28-11-2018
Birth/Age:
Address C/O Jamil Ansari, Hathighisa,
Hathighisa, Sebdella, Naksalbari,
Darjeeling , West Bengal, 734429
Email [email protected]
Gender: Female
Documents to Carry:
Appointment Id: 1721449109235
Aadhaar Seva Ground floor, Mallar
Kendra Address:
Bring original documents for Mukherjee Building, Holding
Enrolment/Update. No photocopy required. No.22/19/18. S.B. Sarani ward
Original documents are scanned and given
back to you. no. XI Rajni Bagan(North),
Carry/Bring appointment print copy. Siliguri, West Bengal, Pin-
734001
Proof of identity: Appointment Date
20-07-2024 (11:10)
Ration /PDS Photograph Card/e-Ration Card and Time:
Proof of date of birth:
Birth Certificate issued by Authorized Authority (in the
respective States) under the Registration of Births and
Deaths Act, 1969 read with Registration of Births and
Deaths Rules 1999/2000/2002 of respective States
Proof of address:
Ration /PDS Photograph Card/e-Ration Card
Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL
AND OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT, 2016
I confirm that I have been residing in India for at least 182 days in the preceding 12 months / I am Non Resident
Indian (NRI) & information (including biometrics) provided by me to the UIDAI is my own and is true, correct and
accurate. I am aware that my information including biometrics will be used for generation of Aadhaar and
authentication. I understand that my identity information (except core biometric) may be provided to an agency
only with my consent during authentication or as per the provisions of the Aadhaar Act. I have a right to access my
identity information (except core biometrics) following the procedure laid down by UIDAI.

Verifier's Stamp and Signature Applicant's Signature/Thumbprint


(Verifier must put her/his name if stamp is not avaliable.)

Note: In case of Child(< 5 Yrs) or Guardian based application, Guardian/Relative will be required to accompany the
applicant. In case of incapacitated person, the signature will be done by Legal Guardian of Incapacitated Person.

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