APPLICATION FORM FOR ISSUE OF NEW RATION CARD / RENEWAL OFRATION CARD 1. Name of the Applicant (In block letters) 2. Father's Name 3. Present Address: Village / Colony / Sector House Number 4. Permanent Address: Village / Colony / Sector House Number 5. Inner Line Pass No. (In case of none Arunachalees) 6. Occupation / Designation 7. Name of the Employer / Department Adult Minor 8. Details of the family members Sl. No Name in Full Age Sex Relationship with Applicant 9. Electoral Roll No. / Census No. 10. Trading Licence No. (in case of Business Community) 11. LPG Consumer No. I do hereby declare that the particulars of my family members shown above are correct to the best of myknowlege and belief. I do not possess Ration Card in my name or in the name of above family members. Signature of Applicant Date
