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Madhu Babu Pension Yojana Application Form

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Madhu Babu Pension Yojana Application Form

Old Age
Pension Type : Name : Pangila Munda
Pension
Father 's/Spouse
: Baya Munda DOB : 03-07-1955
Name

AGE : 68 Aadhar No : 706511911035

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Copy
: Gender : Male
Scan Copy
Age
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Income Scan Proof
Copy
: Income Scan
: Age
Scan Copy Copy Proof

Additional Not
Document
:
Available
Mobile No : 6370165301 District : KENDUJHAR

Sub-division : KEONJHAR Address Type : Block

Block : PATANA GP : CHINAMALIPASI

Village : MAHULDIHA Habitation : MAHULDIHA

House No/Plot
: 1115 PIN : 758029
No

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Categor y(Caste)
: ST Thumb/Signature
:
Impression/Signature
The
parental/family Has not been
income of the convicted of any
applicant is not : Yes criminal offence : Yes
more than involving moral
Rs.60,000/-per turpitude.
annum.
Is a permanent
resident/domicile Application
of Odisha since
: Yes Number
: SSEPD/BNFAPP/MBPY/09/23/2023/59784
20 years.

Bank Account Details

Bank Account Type : Single Account Account Holder Name : Pangila Munda

Upload Passbook Front Page : View Passbook

Account Number : 204534006008014 IFSC Code : IOBA0ROGB01

Bank Name : ODISHA GRAMYA BANK Branch Name : ODISHA GRAMYA BANK

Declaration

I Mr/Mrs Pangila Munda truely declare that:

The parental/family income of the applicant is not more than Rs.60,000/-per annum.

Has not been convicted of any criminal offence involving moral turpitude.

Is a permanent resident/domicile of Odisha since 20 years.

I hereby declare that the details furnished above are true and correct to the best of my
knowledge and belief and I under take to inform you of any changes therein, immediately.In case any of
the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I
 may be held liable for it and that my pension will be terminated.

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