Form-1

MAN HLANNA LEHKHA

(Chang 36(2))

He Man Hlanna Lehkha hian mipa nupui neitu hian a hnuaia ziak
ang hian a nupui man a hlan tih a entir :

1. Innei te hming :

(1) Mipa hming :

Kum zat :

Pa hming :

Khua / Veng :

(2) Hmeichhe hming :

Kum zat :

Pa hming :

Khua / Veng :

2. Man zawng zawng zat :

3. Man pek zat :

4. Man bat zat :

5. |hutphah (A awm chuan) zat :

6. Man hlantute - 1. Signature :

Hming :

2. Signature :
Hming :

7. Man dawngtu :

8. Man hlanna hmun :

9. Man hlan hun leh ni :

10. Inneih ni :

11. Hriatpuitute 1. Signature :

Hming :

2. Signature :
Hming :