3/11/2021 910000490681851777 - Registration Successful - Registration for Inter-District Movement with-in Uttarakhand

REGISTRATION FOR INTER-DISTRICT

MOVEMENT WITH-IN UTTARAKHAND

Thank You
Your ePass application for Movement with-in districts in Uttarakhand is now registered successfully. Status of
Application is - APPROVED.

Applied on: 11-03-2021

Dear TANKASALA KARTHIKEYA,

This pass is not valid for people travelling from abroad. Separate instructions has been issued by
GOI

Application for Movement with-in districts in Uttarakhand only is registered successfully. Treat this as
APPROVAL for movement within green/orange districts in Uttarakhand only as per terms conditions
given below. Your Application No. is 910000490681851777. Journey is valid from 12-03-2021 upto 12-
03-2021 by AIRWAYS, Pass Category: TOURIST - VISIT WITHIN UTTARAKHAND

FAMILY
SR. MOBILE
MEMBER FROM PLACE TO PLACE GENDER AGE
NO. NO.
NAME

DEHRADUN/DEHRADUN/G
DEHRADUN//DEHRADUN/DEHRADUN
K RESIDENCY, CHANDRA
(M.CORP) -RACECOURSE WARD
NAGAR RD, PRINCE
TANKASALA NO.20/112, CHANDRA NAGAR RD,
1. CHOWK, GOVIND MALE 37 8106367145
KARTHIKEYA PRINCE CHOWK, GOVIND NAGAR,
NAGAR,RACE
RACE COURSE,248001 DEHRADUN,
COURSE,248001,
INDIA
DEHRADUN

Note: Traveller from following category/location have to follow the instructions of the state
Government. If fail he/she might be punish under the disaster act.
1. ORIGIN FROM NON HIGH-LOAD COVID INFECTED CITIES.
2. TRAVELING BY FLIGHT & TRANSITING THROUGH HIGH LOAD COVID INFECTED CITIES.
3. LEISURE TRAVELLER (FROM NON HIGH-LOAD COVID AFFECTED CITIES).

Terms & Conditions you agreed on

I declare that the information provided by me is accurate and to the best of my knowledge.

I confirm that I and Other traveller mentioned in form are not diagnosed with Coronovirus (COVID-19)
in last 2 months.

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3/11/2021 910000490681851777 - Registration Successful - Registration for Inter-District Movement with-in Uttarakhand

If information is found false action may be taken in Epidemic act or disaster management act.

The Applicant is not from containment zone in his/her City/ District

I solemnly confirm that, I and Other traveller mentioned in form don't have any symptoms of Flu/Fever.

I solemnly confirm that, I and Other traveller mentioned in form didn't travel to other state in last 14
days.

Authorized Signatory,
District Administration, GOVT OF UTTARAKHAND

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