APPLICATION FORM FOR RATION CARD 1. 2. 3. 4. 5. 6.

Name of the Applicant: ______________________________________________ Fathers name: _____________________________________________________ Designation / Occupation: ____________________________________________ Monthly Gross Income: ______________________________________________ Name of the Department / Village: _____________________________________ Previous Ration Card No: _______________ for _________________ members. PARTICULARS OF THE FAMILY S.No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Name Relationship with the Applicant Age

Signature of the Applicant DECLARATION For Local 1. I hereby declare that I and other member of my family do not possess any land For Non Local 2. I solemnly declare that I have surrendered my Ration Card at Srinagar / Jammu previous place of posting and non of the above family members is Included in the Ration Card out side the District. For Local & Non-Local 3. I solemnly declare that I will be bound to surrender my R.T. at the time of my transfer out side the District.

Attestation of Head of the Officer

Signature of the Applicant