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jäœehL bjhêyhs® ey thça«, br‹id 600 006.

<k¢rl§F/Ïa‰if kuz cjé¤bjhif nfhU« é©z¥g got«

1. gâ¡fhy¤Âš Ïwªj gâahsç‹ :


bga® k‰W« gjé.
(kzkhdtuh/kzkhfhjtuh k‰W«
taJ)

2. Ïwªj nj (Ïw¥ò¢ rh‹W mrš :


Ïiz¡f¥gl nt©L«)

3. m‹dh® gâ brŒj ãWtd¤Â‹ bga® :


k‰W« Kftç

4. thçRjhu® bga®, taJ, KGikahd :


Kftç k‰W« ÂUkz ãiy

5. thça¤jhš tH§f¥g£l bjhêyhs® ey :


ã brY¤Âa ÏuÓ‹ efš

6. mrš Ïw¥ò rh‹¿jœ :


7. thçRjhu® rh‹¿jœ (efš Ïiz¡f¥gl :
nt©L«)

8. Ïwªjtç‹ thçRjhu® x‹W¡F :


nk‰g£lt®fŸ ÏU¥Ã‹ ahU¡F
bjhif tH§f¥gl nt©Lnkh
mtU¡F k‰wt®fëläUªJ bgw¥g£l
jilæšyh¢ rh‹W

9. Ïwªj gâahs® filÁahf bgw¥g£l :


r«gs¢ rh‹W

10. K‹gz ÏuÓJ (Advance Stamped


Receipt)

Ïl«:
ehŸ: thçRjhu® ifbah¥g«.
ãWtd¤jh® rh‹W

gâ¡fhy¤Âš Ïwªj ÂU/ÂUk ..........................................bjhêyhs® ey ãÂ


ϪãWtd¤Â‹ _y« brY¤j¥g£LŸsJ vd rh‹wë¡»nw‹. brY¤Âa tUl« ………….
fhnrhiy/nf£òtiunthiy v©................ ehŸ:………… bkh¤j bjhif %..................(thça
uÓJ v©. ehŸ: )

mYtyf K¤Âiu: ãWtd¤jhç‹ ifbah¥g«.

F¿¥ò:
1. t.v© 7š F¿¥Ã£LŸs thçRjhuç‹ rh‹W, gÂÎ bg‰w mYtyç‹ (Gazetted
Officer) rh‹bwh¥g« bg‰W Ïiz¡f¥gl nt©L«.

2. nk‰go é©z¥g« rçahd Kiwæš ó®¤Â brŒJ Ïiz¥òfSl‹ “brayhs®,


jäœehL bjhêyhs® ey thça«, njdh«ng£il, br‹id-600 006,
j. bg. v©.718.” v‹w Kftç¡F gâahs® Ïwªj njÂæèUªJ MW
khj¤Â‰FŸ mD¥Ã it¡f¥gl nt©L«.

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