42 SACHIVALAYAM(BALARAMUNIPET-2)

ELECTION WARD NO : 16 SECRITIRATE NO : 21070042

CLUSSTER S.L.NO : C5 VOLUNTEER NAME : GANDIKOTA VENU GOPAL

DOOR NO : 9/514 I.D. NO : 14976333

NAME OF THE FAMILY HEAD : VEMULA YEDUKONDALU CAST : BC-A (VADDERA)

F/O, M/O,W/O,D/O & S/O & : RAMARAO CAST CERIFICATE NO :

RATION CARD NO & TYPE : WAP0681018A0261 OWN / RENT HOUSE : OWN

AADHAR NO : 5616 6362 1276 MUNICIPAL TAX NO : 1070007747

PAN CARD NO : WATER TAX NO : 1070016884

MOBILE NO : 7095871614 OCCUPATION : COOLI (CONCREET)

D.O.B & AGE : 1975 (45) VOTER ID NUMBER : AP120890405079

PENSION I.D NO. & DETAILS :

GOVERNAMENT EMPLOYEE / PENSIONER : --- IF YOU YES TEL ME DETAILS :

SL.N NAME OF THE FAMILY RELATION AGE & DATE OF GENDER MARIT AAADHAR CARD SCHOOL
O. NUMBER BIRTH A NO. NAME
STATUS

1. VEMULA LAKSHMI WIFE 01-01-1977(43) FEMALE 7488 2034 5821

ELECTION CARD PAN CARD PHONE NO. QUALIFICA OCCUPATION GOVT.PENSI BANK DETAILS
NO. NO. TION & INCOME ON I.D &
BENIFIT

AP120890408471 BTXPVO121Q COOLI

(CONCREET)

RICECARD NUMBER: 2810775911 RATION DEPO NUMBER :

AMMA VADI CARD NUMBER: VIDYA DEVANA NUMBER :

HOUSESITE AND G+3 APPLY/NOT : YES/NO

HOUSE SITE ELIGIBLE/NOT NUMBER: REMARKS:

G+3 ELIGIBLE/NOT NUMBER: REMARKS:

IF ANY PERSON ELIGIBLE FOR GOVERNAMENT PENSION :

(KAPU NESTAM/TAILORS/PASTORS/RAJAKAS/NAIBRAHMIN)

ANY REQUIRMENT DOCCUMENTS :

FAMILY MEMBER SIGNATURE VOLUNTEER SIGNATURE

GANDIKOTA VENU GOPAL (42 SACHIVALAYAM WARD VOLUNTEER)Page 1