GOVERNMENT OF JAMMU AND KASHMIR DIRECTORATE OF SOCIAL WELFARE Application Form for Availing Petrol Subsidy to Disabled Persons 1. Name and Address of the Physically Handicapped Person: 2. Nature of the Handicapped : 3. Occupation ( whether State Government Employed or State Government Employed): 4. Place of duty and approximate distance From the employee's house: 5. Registration No. of vehicle and its Horse Power: 6. Name and full address of the driver Who drives the vehicle for blind applicant: 7. Name and Address of the Supplier from whom the applicant wishes to buy petrol This is certified, I ________________________ D/o/S/o _______________________ Am not in receipt of any State of Voluntary Source for the purchase for which subsidy on purchase of petrol/diesel is meant and also certified that my income from all the sources does not exceed Rs 2500/-per month. Signature of the Applicant Part II 1. Registration Number of the Vehicle : 2. Monthly entitlement of petrol/Diesel at Concessional Rate : 3. Vehicle of 2Horse Power and Below Vehicle of more than 2Horse Power : 15 liters per month More than 15 liters per month Director Social Welfare
