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Application for NRK ID Card

Application for NRK ID Card

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Published by bkgielts

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Published by: bkgielts on Aug 24, 2009
Copyright:Attribution Non-commercial

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07/06/2010

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(Use only Capital Letters for filling the Data sheet)1.Name(as in passport)
t]cv(]mkvt]mÀ«n DÅXpt]mse)
2.Passport Number(
]mkvt]mÀ«v \¼À
) Place of issue date of issue(
\ÂInb Øew) (\ÂInb XobXn)
3.Address in Passport
(]mkvt]mÀ«nse
 
A{UÊv 
)4.Profession (
sXmgnÂ)
5.Date of Birth(
P\\XobXn
)6.Address abroad (
hntZis¯ hnemkw
) E-mail (
CþsabnÂ
)Telephone (
t^m¬
)7.Addresses in Kerala(
tIcf¯nse hnemk§Ä)
I. Permanent Address in Kerala
(tIcf¯nse Øncw taÂhnemkw)
II. Present Address in Kerala
(tIcf¯nse Ct¸mgs¯ taÂhnemkw)
8.a) Duration of Overseas stay(
hntZi¯v F{X ImeambnXmakn¡p¶p)
b) Specify the period (
Imebfhv hyàam¡pI)
9.Details of Sponsor(
kvt]m¬kdpsS hnhc§Ä)
Cu At]£m^mdw kuP\yamWv 
H¸nSm¯ IfÀt^mt«m ]Xn¡pI
3.5X3.5 size
{]hmkn Xncn¨dnb ImÀUv 
At]£m^mdw (hntZiw)
Day
Znhkw
Month
amkw
Year
hÀjw
NORKA-ROOTS, Top Floor, Centre Plaza, Vazhuthacaud, Thiruvananthapuram-695 014, Kerala, India
+ 91-471-2332416 2332452 Fax:+91-471-2326263, e_mail: nrkroots@asianetindia.com, URL: www.norkaroots.net, www.norka.gov.in
NORKA
A GOVERNMENT OF KERALA ENTERPRISE
PINDay
Znhkw
Month
amkw
Year
hÀjw
Contd. 2
]©mb¯nsâ t]cv 
Taluk (
Xmeq¡v 
)District (
Unkv{SnIvSv 
)Telephone (
t^m¬
)Taluk (
Xmeq¡v 
)District (
Unkv{SnIvSv 
)Telephone (
t^m¬
)

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