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Please affix a

APPLICATION FORM FOR IDENTITY CARD recent

passport size
Under clause no.60 (1) of P&T Guide accompanying two photographs (passpport size) photograph

1. Identity Card No. (To be filled by DO)

2. Name

3. Father's Name

4. Unique Employee ID

5. Designation

6. Date of Birth

7. Complexion

8. Height

9. Blood Group

10. Personal marks for identification


a

b)
11. Personal Address (Official)

12. Personal Address (Residential):

13. Mobile No.

14. Name of the Office

15. Name ofthe Account Office

Date : Signature of the Applicant

Certified that . is personaly known to me and that particulars


filled in the form above are correct.

Verified

Signature with designation of


Verifying Officer

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