ANNAI TERESA ORPHAN GIRL MARRIAGE FINANCIAL ASSISTANCE SCHEME 1 2 Name and address of the orphan girl Details

of death of father & mother of the orphan girl a. Name b. Date of death c. Place of death d. Reason for death Guardian’s name and relationship to the orphan girl Details of brothers / sisters of the orphan girl Brother Name Sister name Age : :

3 4

: :

5 6 7 8 9

Age of the orphan girl to be married Occupation / Income of the orphan girl Bridegroom’s name & address Purpose of financial assistance requested Place and date of marriage

: : : : :

Place: Date:

Applicant’s Signature (Bride)

Certificates to be enclosed:1. Death certificate of father & mother or orphan certificate 2. Income certificate from Tahsildar (Income limit Rs.12000/- per annum) 3. Marriage Invitation 4. Age proof of the bride 5. Bride’s photograph Bills towards purchase of marriage articles for Rs.1000/14

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