Form 2 - LPG Linking Form (To be submitted to LPG Distributor) Step 2 . Take photocopy of this sheet & fill-up the following details in the photocopy in BOLD BLACK / BLUE ink: | Sr. No. Step 1. Place your Original Aadhaar Letter here as shown below: 1, NAME OF COMPANY (e.g. IOCL/BPCL/HPCL) be Be. 2, NAME OF DISTRIBUTOR ae Sure jn e age of DGCC booklet or recent cash memo) Tats herp Lnroumont no. 70/1238 4. LPG ID (17 Digit No.) Bees ~ CCC _—— 5, NAME OF THE LPG CONSUMER 6. YOUR REGISTERED MOBILE NUMBER or MOBILE NUMBER WHERE WE CAN CONTACT YOU +E T TTT I 7. ADDRESS (Fill this only if your present LPG = delivery address is different from address in the ‘De waS omg 7 Your Aadhaar No. : ‘Aadhaar Card, please attach a current proof of 8829 2035 8586 address**) weE - PEMD ry Place: Date: Signature of the Consumer Enclosures: 1. Fist page of DGCC booklet or copy of recent cash meme, 21 Photocopy of proof of adress If your address with LPG distributor differs from address in Aadhaar Letter. *In case you have an e-Aadhaer, please fold it vertically and keep the left side (the side with your photo and Aadhaar Number as shown above) In the space provided above and follow the instructions as above. **address Proof (Photocopy of any one of the following): + Aadhaar (UID) letter « Lease Agreement « Telephone or Electricity Bill or any other Utility Bill * Self-declaration attested by Gazetted Officer « Flat allotment or possession letter « LIC Policy « Driving License + Voter ID + Passport + Ration Card + House Registration Document. rests nececinscneacecsecseaensstnca ACKNOWLEDGMENT SLIP: Received ‘Aadhaar LPG Linking Form’ from (Name), J Consumer No, alongwith copy of Aadhaar. Date: Sign & Stamp of Gas Distributor