•JTTCcf itKcfrK Government of India

W T P J v£vSff f^TFT Department of Atomic Energy

WTT^T ^TT3T General Services Organisation

APPLICATION FOR ALLOTMENT OF COMMON GARAGE IN DAE TOWNSHIP, KALPAKKAM/ANUPURAM

1. Name (in Block Letters)

2. Designation

3. *T.^.?f. I.C.No.

4. Section/ Unit

5. Phone No.

STTcTRT Residence :

6. Present Basic Pay & DNI

7. •^.12,000/- 3cH Date of acquiring pay of

viMlfad fcTf§T Rs. 12,000/-

8. PiyRkl fel1§T Date of appointment

9. vJFT fcTf^T Date of birth

10. Vehicle Regn.No. & Model

(Attach registration copy)

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11. MAIC| eivviRm, Present Residents

cbcMI<W>^l/iHuj^^^ 3 address in DAE Township,
Kalpakkam/Anupuram
cld~HH 3JNKJ|i| rrcTT

12. Remarks, if any

3TTcT^f) % 'gWTCTC' Signature of the Applice

aji^cb u*imPicb <b\u\o\u it 3rdfocT ffcm urn?

TO BE FORWARDED THROUGH APPLICANTS ADMINISTRATIVE OFFICE

SfT^cf) 5RT ttK f ^ ? ^ fcTcRTfT Wi >He^J IMH ^ 4 ^T^t WTf The Particulars given by the applicant above have
been verified and found correct.

ITJdTCR" Signature :
q q - l H Designation :
Unit :

^cfj *f To
WFtf $$m$\e Officer, >HI^>H GSO

*GSO/HINDI/HE FORMS/EM/GARAGE ALLOT/1