AADHAAR ENROLMENT

FORM
Aadhaar Enrolment is free & Voluntary.

Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT,2016
(Aadhaar Act)
Submission Date: 5-Dec-2019 Application Type : UPDATE Aadhaar No.: 727089701534
Fields to be Updated in existing Aadhaar :Address, Biometric(Photo/Iris/Fingerprint), Mobile No

Application Details Appointment Details

Name: Rahul K

Mobile
9743662716
No:

C/O K S Krishna, #570, Basavangudi road, Yelwala

Address: hobli, Belavadi, Mysuru, Mysore, Karnataka,
570018

Appointment ID: 1000000098964

#532,Ground Floor,CCK
Complex,,New Kalidasa
Aadhaar Seva
Road,Opposite To MUDA
Kendra Address:
Complex,,Vijaynagar 1st
STAGE,Mysore,570017

Appointment Date: 6-Dec-2019

Time Slot: 10:45

Amount: Rs. 50

Payment Status: Cash

GSTN : 07AAAGU0182Q1ZS

Documents to Carry

1. POA: Certificate of Address issued by Village Panchayat head or its equivalent authority (for rural areas)

Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND
SERVICES) ACT, 2016
I confirm that I have been residing in India for at least 182 days in the preceding 12 months & information (including biometrics)
provided by me to the UIDAI is my own and is true, correct and accurate. I am aware that my information including biometrics will be
used for generation of Aadhaar and authentication. I understand that my identity information (except core biometric) may be provided to
an agency only with my consent during authentication or as per the provisions of the Aadhaar Act . I have a right to access my identity
information (except core biometrics) following the procedure laid down by UIDAI.

Verifier s Stamp and Signature: Applicant s signature/Thumbprint(Verifier must put his/her Name, if stamp is not available)
Applicant s signature/Thumbprint

Instructions

1. Please reach 15 min early at Aadhaar Seva Kendra and carry printed copy of this Application Form.
2. Carry all the Document(s) selected while filling up the form.
3. In case of Child (5Yrs) or Guardian based application, Guardian/Relative will be required to accompany the applicant.
4. In case of incapacitated person, the signature will be done by Legal Guardian of Incapacitated Person
 List of POI Documents List of POA Documents

1. Passport 1. Passport
2. PAN Card 2. Bank Statement/ Passbook
3. Ration/ PDS Photo Card 3. Post Of f ice Account Statement/Passbook
4. Voter ID 4. Ration Card
5. Driv ing License 5. Voter ID
6. Gov ernment Photo ID Cards/ serv ice photo identity card issued by PSU 6. Driv ing License
7. NREGS Job Card 7. Gov ernment Photo ID cards/ serv ice photo identity card issued by PSU
8. Photo ID issued by Recognized Educational Institutio 8. Electricity Bill (not older than 3 months)
9. Arms License 9. Water bill (not older than 3 months)
10. Photo Bank ATM Card 10. Telephone Landline Bill (not older than 3 months)
11. Photo Credit Card 11. Property Tax Receipt (not older than 1 y ear)
12. Pensioner Photo Card 12. Credit Card Statement (not older than 3 months)
13. Freedom Fighter Photo Card 13. Insurance Policy
14. Kissan Photo Passbook 14. Signed Letter hav ing Photo f rom Bank on letterhead
15. CGHS / ECHS Photo Card 15. Signed Letter hav ing Photo issued by registered Company on letterhead
16. Address Card hav ing Name and Photo issued by Department of Posts 16. Signed Letter hav ing Photo issued by Recognized Educational Institution on
17. Certif icate of Identif y hav ing photo issued by Gazetted Of f icer or letterhead or Photo ID hav ing address issued by Recognized Educational
Tehsildar on letterhead Institution.
18. Disability ID Card/handicapped medical certif icate issued by the 17. NREGS Job Card
respectiv e State/UT Gov ernments/Administrations 18. Arms License
19. Bhamashah Card 19. Pensioner Card
20. Certif icate f rom Superintendent/ Warden/Matron/ Head of Institution of 20. Freedom Fighter Card
recognized Shelter Homes f or Orphanages, Homes etc on their of f icial 21. Kissan Passbook
letter head. 22. CGHS / ECHS Card
21. Certif icate of Identity hav ing photo issued by MP or MLA or MLC or 23. Certif icate of Address hav ing photo issued by MP or MLA or Gazetted Of f icer
Municipal Councillor on letterhead or Tehsildar on letterhead
22. Certif icate of Identity hav ing photo issued by v illage panchay at head or 24. Certif icate of Address issued by Village Panchay at head or its equiv alent
mukhiy a or its equiv alent authority (f or rural areas) authority (f or rural areas)
23. Gazette notif ication f or name change (with separately af f ixed photo) 25. Income Tax Assessment Order
24. Marriage Certif icate with photo 26. Vehicle Registration Certif icate
25. RSBY Card 27. Registered Sale / Registered Lease / Registered Rent Agreement
26. SSLC book hav ing candidates photo 28. Address Card hav ing Photo issued by Department of Posts
27. ST/ SC/ OBC Certif icate with photo 29. Caste and Domicile Certif icate hav ing Photo issued by State Gov t.
28. School Leav ing Certif icate (SLC) / School Transf er Certif icate (TC), 30. Disability ID Card/handicapped medical certif icate issued by the respectiv e
containing name and photo State/UT Gov ernments/Administrations
29. Extract of School Records issued by Head of School containing name and 31. Gas Connection Bill (not older than 3 months)
photo 32. Passport of Spouse
30. Bank Pass Book hav ing name and photo 33. Passport of Parents(in case of Minor)
31. Certif icate of Identity containing name and photo issued by Recognized 34. Allotment letter of accommodation issued by Central/State Gov t. (not more
Educational Institution signed by Head of Institute than 3 y ears old)
35. Marriage Certif icate Issued by the Gov t., containing name and address
List of DOB Documents 36. Bhamashah card
37. Certif icate f rom Superintendent/ Warden/ Matron/ Head of Institution of
recognized shelter homes f or orphanages etc. on letter head
1. Birth Certif icate
38. Certif icate of address hav ing photo issued by Municipal Councilor on
2. SSLC Book/Certif icate
letterhead
3. Passport
39. ldentity Card issued by recognized educational institutions
4. Certif icate of Date of Birth issued by Group A Gazetted Of f icer on
40. SSLC book hav ing photo
Letterhead
41. School ldentity Card
5. PAN Card
42. School Leav ing Certif icate (SLC) / School Transf er Certif icate (TC),
6. Mark sheet issued by any Gov ernment Board or Recognized Univ ersity
containing Name and Address
7. Gov ernment Photo ID Card/ Photo Identity Card issued by PSU
43. Extract of School Records containing Name, Address and Photo issued by
containing DOB
Head of School
8. Central/ State Pension Pay ment Order
44. Certif icate of Identity containing Name, Address and Photo issued by
9. Central Gov ernment Health Serv ice Scheme Photo Card or Ex-
Recognized Educational Institution signed by Head of Institute
Serv icemen Contributory Health Scheme Photo card.
10. Gov ernment issued certif icate (or card) hav ing photo and duly signed by
the signing authority
11. Photo ID hav ing Date of Birth issued by Recognized Educational
Institution
12. School Leav ing Certif icate (SLC) / School Transf er Certif icate (TC),
containing Name and Date of Birth
13. Extract of School Records issued by Head of School containing Name,
Date of Birth and Photo
14. Certif icate of Identity containing Name, DOB and Photo issued by
Recognized Educational Institution signed by Head of Institute

List of POR Documents

1. PDS Card
2. NREGS Job Card
3. CGHS/State Gov ernment/ECHS/ESIC Medical card
4. Pension Card
5. Army Canteen Card
6. Passport
7. Birth Certif icate issued by Registrar of Birth, Municipal Corporation and
other notif ied local gov ernment bodies like Taluk, Tehsil etc.
8. Any other Central/State gov ernment issued f amily entitlement document.
9. Marriage Certif icate issued by the gov ernment
10. Address card hav ing name and photo issued by Department of Post
11. Bhamashah Card
12. Discharge card/ slip issued by Gov ernment hospitals f or birth of a child
13. Certif icate of ldentity hav ing photo issued by MP or MLA or MLC or
Municipal Councilor or Gazette Of f icer on letterhead
14. Certif icate of ldentity hav ing photo and relationship with HOF issued by
v illage panchay at head or mukhiy a or its equiv alent authority (f or rural
areas)
Customer Process Flow