7.

IN S TR U C TIO N S FO R FILLIN G TH E FO R M
PLE AS E FO LLO W TH E SIM P LE STEPS W H ILE FILLIN G THE FO R M S
1.

Use the B LACK B AL L PEN to fill the details and to sign the form .

2.

Do not put any stray m arks on Black Squares and Barcode.

3. Fill com plete circles for the selected options else leave it blank if not applicable as shown in the exam ple:

4. W rite clearly within the boxes, as indicated in the following exam ple:

5.

Do not over write.

6.

Please write the date in DD-M M -YYYY form at.

7.

Do not bend/fold the form .

8.

Please refer the table below for State Codes.

S T ATE /U T C O D E

S T AT E /U T N AM E

S T ATE /U T C O D E

S T AT E /U T N AM E

AN

ANDAMAN AND NICOBA R

LK

LAKS HADEEP

AP

ANDHRA PRADES H

MP

MADHYA PRADESH

AR

ARUNACHAL PRADES H

MH

MAHARAS HTRA

AS

ASSAM

MN

MANIPUR

BH

BIHA R

MG

MEGHALAYA

CH

CHANDIG ARH

MZ

MIZORAM

CG

CHHATISGARH

NG

NAGALAND

DN

DADRA AND NAGA R HAVE LI

OR

ORISSA

DD

DAMAN & DIU

PN

PONDICHERRY

ND

DELHI

PB

PUNJA B

GA

GOA

RJ

RAJAS THAN

GJ

GUJARAT

SK

SIKKIM

HR

HARYANA

TN

TAMIL NADU

HP

HIMACHAL PRADES H

TR

TRIPURA

JK

JA MMU & KAS HMIR

UP

UTTAR PRADESH

JH

JHARKHAND

UT

UTTARAKHAND/UTTRANCHAL

KR

KA RNATAKA

WB

W ES T BE NGAL

KL

KE RALA
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