Annexure – B

GOVERNMENT OF INDIA
MINISTRY OF COMMUNICATIONS
DEPARTMENT OF POSTS
Photograph
of applicant
Application No._________ signed
by the
Application for Franchisee applicant
Part – A (To be filled by the applicant)

1. Name of Applicant (in block letters) J. KARTHEKA

2. Father’s Name JAYAGOPU

3. Nationality INDIAN

4. Age:
(Should be 18 years or above on the date of 07-12-1987 (37 YEARS)
application, proof to be attached) AADHAR COPY ATTACHED

5. Mobile Number & Email ID 75021 30626

VTSTECH.VPM@GMAIL.COM

6. Whether Department of Posts (DoP) pensioner No

(Yes/No)
7. Aadhaar and Income Tax PAN
(In case Pan No. is not provided, declaration in form 60 AADHAAR NO. 5302 5806 2367
to be provided) PAN NO. EMZPK8499C

7. 1) GSTIN, if available ---

8. Educational Qualification (Proof to be attached) B.Sc., MBA.,

VISALAKSHI ILLAM, 4/224, NGGO’S COLONY,

9. Permanent Address: SALAMEDU, VILLUPURAM - 605403

10. Correspondence Address: No. 642, KRISHNA COMPLEX, NEHRUJI ROAD,

VILLUPURAM- 605 602
11. Location from where business will be conducted NEAR SHANTHI THEATRE BUS STOP
VILLUPURAM
12. Details of premises from where business is to be
conduced : RENTAL SHOP
Whether owned / rented /leased if not owned, indicate RENTAL AGREEMENT VALID UPTO 31ST MARCH 2026
period up to which present rent / leased agreement is
valid:

13. Distance of premises from the nearest Post Office: 2 KM FROM VILLUPURAM HPO

14. Indicate present business / occupation, if any and VTS TECHNOLOGY

whether it is intended to be carried on from the same
premises / address as the postal franchise;
15. Please indicate previous experience, if any, in
retailing services:
16. Do you have knowledge of working on a computer
and would you be using a computer for providing this
service?
(INTERNET BROWSING CENTRE & E-SEVAI MAIYAM)
DOING ALL ONLINE APPLICATION AND ONLINE
PAYMENTS WORKS FROM PAST 15 YEARS
YES
Diploma – MS OFFICE WORD & EXCEL
Diploma - ADVANCE SOFTWARE TECHNOLOGY
17. Whether all the required IT hardware peripheral viz. YES
Desktop computer / Laptop /, Printer, weighting scale, ( AVAILABLE – COMPUTERS, XEROX, COLOUR
bar code Scanner, active internet connectivity is PRINTER, BIOMETRICS FINGER PRINT SCANNER,
available: LAMINATION ETC.,)

1) Mr. RAGUNATHAN, Auditor,

VASANTHAM ADVISORIES PVT, LTD.,
18. Name, address and telephone number of 2 2, CHAIRMAN GOVINDHARAJ STREET,
respectable persons of he locality who can be VILLUPURAM – 605 602
contacted for reference: CELL: +91 97911 00044

2) SOORIYANARAYANAN, NSS ADD

SUBARAYAN COMPLES,
NEHRUJI ROAD,
VILLUPURAM – 605 602
CELL: 98423 87921

19. Business Plan:

20. Details of Security furnished:

I agree to abide by all the terms / conditions mentioned in the franchising agreement & license.

Declaration:

I, J. Kartheka w/o _R. Karthikeyan, resident of 4/224,(New No. 145) Visalakshi Illam, NGGO Colony, Salamedu,
Villupuram declare and undertake that the above information is wholly true. I have read and understood the terms and
conditions under the Franchisee Scheme. I hereby agree to abide by them. I also agree to abide by any changes that may
be made in them from time to time.
Place: Villupuram
Date:
Signature of the Applicant
……………………………………………………………………………………………………………………………………………..
DEPARTMENT OF POSTS
(Acknowledgement)

Received one application for franchising from Mr./Mrs/Ms. ………………………………………………

(Name and address of the applicant)

Daily Dak No……………………………………..

Receipt Assistant
Office Stamp

“ Note: Application cum Franchise Agreement Form is also available at the concerned Postal Divisional Office and duly
filled up Application From & other documents are to be submitted to the Sr./Superintendent of Post Offices of the
concerned Postal Divisional Office, the competent authority for grant of license under the Scheme. For more details
about scheme may contact Sr./Superintendent of Post Offices of the concerned Postal Divisional Office

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