FORMAT 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 6. Permanent Address: Village ................... PO ................... PS ................... District ................... State ................... 7. Identification Mark ................... 8. Height ................... 9. Colour of Eye ................... 10. 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 of my knowledge and belief. I understand that in the event of any information being found false or incorrect at any state, I am liable 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 employees 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 per service book. Signature with Date Name : Seal :
