Unique ldentilication Authority of lndia

ffi Government of lndia

under section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIA! AND OTHER SUESIDIES, BeHerttS AIO SElvicEs) Acl 2016 (Aadhaar Act)
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AADHAAR

AADHAAR ENROLMTNV CORRECTIONI UPDATE FORM

Aodhoot Enrclment ond Monddtory Eiometilc Updote ts free. No chatget art appllcobla for Form. ln cose ol Corrcction/ Updote, provlde yqutAadhoor Numbet
(lJtD), Full Nomc ond only that freld whlch nead, Coficctlon/ Updota,

n Resident I Non-Residentlndian(NRl*) Pleaselollowthelnstructionsoverleafwhttefilltnguptheloffi.Usecdpltal lettersonly.

Pre Enrolment lD (lf applicable): ln case of Update provide Aadhaar Number (UlD)
1 2

2.7 IBiometric Update (Photo + Fingerprint + lris) f]Mobile flOate of Birth IAddress [ruar" f]Gender f e mail

3 Full Name:

Age: Yrs OR Dateof Birth: I':l: ili'lj'l i'i

4 Gender: Iruate f] remale !Transgender 5
! Declared ! Verified
Address: C/o ', r;i,-rl

House No./ Bldg./ Apt: Street/ Road/ Lane

Landmark Area/ Locality/ Sector:

6
Village/ Town/ City: Post Office:

District 5ub-District State:

E-Mail i Ii IIIi Ii MobileNo.: I PlNCode: i i : i i

Details of: flrather !ruother f]Guardian IHusband lwite

For childrcn below 5 yeorc qre
Fathir,/Mothet/Guordion's detoils mondotory. Adults con opt not to tpecify this information.
7
Name

EID/AadhaarNo.: I i i , i I ; I ; I I I t ] ,ddlr*rrr jyyyylhhrrl*r:srl

Verification Type: nDocument Based [-llntroducer Based IHead of Family (HoF) Based
Select only one of the above. Select lntroducer or Head of Family only if you do not possess any documentary proof of identity and/
or address. lntroducer and Head of Family details are not required in case of Document based verification.

8 For Docu ment BaSgd /Wrire ryom es ol the documents produced. Refer overleql ol this fotn for list ol valid
PC)t o, Y{JA

c. DOB d. POR
(Mondatory in cdse of Verified Dote of Bhth) (Mondotory in cose of HoF bosed Enrclment/ Updote)

For lntroducer Based

For HoF Based - Details of :IFather f]Mother IGuardian l-lHusband f]wite
- lntroducer's
i,l i illl
9
AadhaarNo.: I , I I , , I I I
HoF'sElD/AadhaarNo.: ll;l l

.:( tf',,,ryrli ' '

I hereby confirm the identity and address of as be ing tiue, correct and accurate.

lntroducer/ HoF's Name: Signature of lntroducer/ HoF

Disclosure under section 3(2) of TilE AADHAAR {IARGETED DEIIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES} ACf, 2016
I confirm that I have been residing in lndia for at least 182 days in the preceding 12 months / I am Non Resident lndian (NRl) & 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 ofthe AadhaarAct. I have a right to access my identity information (except core biometrics) following the procedure laid down by UlDAl.

Verifier's Stamp and Signature:

(Verifier must put his/ her Name, if stamp is not available) Applicant's signature/ Thumbprint

To be filled by the Enrolment Agency only: Date & time of Enrolment:

Note: ln cose ol mino4 the tlgnoture will be done by porent/guodian, ln cose ol incspocitoted pe6on, the slgnoture will be done by Legal Guordlon of lncopscltqted Pe6on
' ln eose of NRl, only lndion PosspotT will be volid os POt.