APPLICATION FORM FOR PERMANENT RESIDENT CERTIFICATE GOVERNMENT OF ARUNCHAL PRADESH OFFICE OF DEPUTY COMMISSIONER (O New O Duplicate) (To be filled up by the Applicant) 1. Full Name of the person for whom PRC is required Attach two attested passport size photos 2. Father's/ Husband' s Name 3. Name of Tribe 4. Name of Applicant Permanent address Village/Town Post office Circle Police station District State 5. Village/sector/colony 6. Present Address C/o Post office Police station District Circle Published on National Portal of India (india.gov.in) Memo no. Dated SL no. 8 for Duplicate cases only Dated 7. No. of years of residence at present address 8. Age 9. Purpose for which PRC is required 10. Reference of ST Certificate (in years) 11. Original PRC no. 12. Contact No. I do hereby declare that the above particulars are true and correct to the best of my knowledge and belief. I shall be punishable in the event of finding any of the above particulars false, even in future. Remarks and recommendation of certifying Authority with seal Signature of Applicant Name Designation Address Enclosures: Affidavit in Standard format. Xerox copy of ST certificate. Passport size photo - 2 nos. 1. 2. 3. Published on National Portal of India (india.gov.in)
