You are on page 1of 2

Conversion of White Card to Pink Card Conversion of White Card to Pink Card

Ration Card Transfer Application Form


Request Details
Ration Card No*:

Card Transfer Details


House No. to be changed*:

Landmark/Locality/Colony to be changed*:

District to be changed*:

Mandal to be changed*:

Ward/Village to be changed*:

Pin code to be changed *:

Proof Document 1 of Card Transfer*:  Affidavit


 Certificate from Present FP shop for Commodities not lifted
 Self Declaration
Proof Document 2 of Card Transfer*:  Driving License  Rental Agreement  Electricity Bill
 Bank Pass book  LPG Receipt  Notary  Telephone Bill

Informant Details
Informant Name*:

Relation*:

Mobile No*:

Delivery Type*:

Reason for Ration Card Transfer*:

Old Ration Card Collected from the Applicant*:  Yes  No

Documents List
(NOTE: 1. All Upload Documents should be in PDF Format only 2. Each file should not exceed 50KB)

1. Application Form*

2. Affidavit/Self Declaration/Certificate from Present FP shop for Commodities not lifting:*

3. Driving License/Rental Agreement/Electricity Bill/Bank Pass book/LPG Receipt /Notary /Telephone


Bill:*
Applicant’s Signature

You might also like