FORM FOR APPLICATION OF IDENTITY CARD (To be filled in capital letters) 1. Name 2. Father's / Husband's Name 3. Employer / Department 4. Present Address : Village PO PS District State : Arunachal Pradesh 5. Permanent Address : Village PO PS District State 6. Identification Mark 7. Height 8. Colour of Eye 9. Have you previously held any I / Card ( If so give details ) I hereby declare that the above particulars given in the application are true, complete and correct to the best ofmy knowlege and belief. I understand that in the event of any information being found false or incorrct at any state, I amliable for legal action.Enclosed : Two nos. of Passport photograph. Signature with date CERTIFICATE TO BE GIVEN BY THE CONTROLING OFFICER( To be recommended only on completion of 2 (two) years regular service of Arunachal Pradesh Government employee only. ) Certified that Sri / Smti Son / daughter / wife of is working in this establishment as since He/ She is a regular employee of this Department and his / her permanent home address as mentioned above is as perservice book Signature with Date Name Seal :
