Download Common Application Form for Citizen Services

Common Application Form to be used in e-Suvidha Centres in the State of Tripura / / 2 0 0 Dated: To The Sub-Divisional Magistrate, _________________________________________ Sub: Prayer for ________________________________________________________ Sir, I would like to avail of the aforesaid Service from your Office. My personal details are as under: 1. Applicant Name 2. Father's / Husband's Name 3. Guardian Name 4. Relationship with Guardian: Son/ Daughter/ Wife/Husband/Brother/ Sister/ Other_______________________ 5. Address Village Road/ Lane Post Office Police Station Communication Permanent / / 6. Date of Birth: 7. Religion: Hindu/ Muslim/Christian/ Others________________________________________________________ 10. Qualification: Illiterate/CEC/ Class V/Class X/Secondary/Higher Secondary/Graduate/Post Graduate and above. The list of supporting documents in support of my request is as under: Supporting Document Name Reference Issuing Office No. Date 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 8. Caste: General/ST/SC/OBC/ Religious Minority 9. Community ______________________________ Sl. 14. Thanking you. Yours faithfully (Signature of the Applicant) For Official Use Only Tehsildar's Remark: Revenue Inspector's Remark: __________________________________________________________________________________________________________ DCM's Remark: In case the Applicant is represented, one passport size photograph of the applicant should be brought along. Sl No Documents Required 1. Citizenship Certificate, Ration Card, Land Documents/AMC Documents, Tehsil Enquiry and School Certificate. 2. Citizenship Certificate, Ration Card, Tehsil Enquiry, Land Document and (School Certificate showing 10 yrs continuation stay in Tripura/ Certificate of parents showing 10 yrs continuation stay in Tripura for NERIST Entrance Examination) / (School Certificate from Class I to XII for Joint Entrance Examination) 3. Self Declaration of Income, CRC, Ration Card, DDO Certificate, Gazetted Officers Certificate, Tehsil Enquiry, Land Document 4. Citizenship Certificate, Community certificate, Family Ration Card, ST Certificate of Father/Brother/Sister, Blood Relation Certificate, Tehsil enquiry, School Certificate, Land Document, Photo 5. Prescribed Application Form (Annexure-2), Citizenship certificate, PRC, Income certificate (MLA/Commissioner/Gazetted officer), Community Certificate, Tehsil Enquiry, Land Document, Photo 6. Prescribed Application Form (Annexure-2), Citizenship certificate, PRC & Income Certificate from Deputy Collector & Magistrate, Community Certificate, Tehsil Enquiry, Advertisement of Central Govt. against post, Land Document, Central Document, Qualification Document, Photo 7. Death Certificate, Family Ration Card after deleting the name of deceased, Affidavit from Judicial Magistrate by Applicant showing survivors, Land Documents, AMC Documents, Certificate from Gazetted officer showing survivors, Panchayat ROR, Tehsil enquiry, Land Document 8. SP (DIB) Report, CRC, Ration Card, An Affidavit from Judicial Magistrate, Enquiry Report from Deputy Collector & Magistrate. 9. Certified Copy of ROR, Tehsil enquiry 10. Documents to be sent by Political Department (Home Affairs) 11. PRC of Husband & Wife, Age proof of Husband & Wife, Citizenship certificate of Husband & Wife, Sterilization Certificate and Coupon, Birth Certificate of Children, Age proof of applicant, Undertaking in original, Department Cerificates (Employees), and Tehsil Enquiry. 12. Citizenship of either of Parents, Certificate of Pradhan, Certificate of Doctor, Tehshil enquiry (In case delayed registration an affidavit from judicial magistrate showing date of birth and place of birth) 13. Citizenship certificates of Deceased /parents, Certificate of Pradhan, Certificate of Doctor, Tehshil enquiry (In case delayed registration an affidavit from judicial magistrate showing date of birth and place of birth) 14. Fee Card, School certificate, CRC, Gazetted officer/ MLA/ Pradhan Certificate, Ration Card, Panchayat ROR 15. Copy of Existing License 16. Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness 17. Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness 18. Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness 19. Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness 20. Treasury Challan for Rs. 1000 21. Enquiry Report from Police 22. Treasury Challan for Rs. 10, GD entry in respective PS 23. Treasury Challan for Rs. 10, GD entry in respective PS 24. Treasury Challan for Rs. 10, GD entry in respective PS 25. Treasury Challan for Rs. 10, GD entry in respective PS 26. Treasury Challan for Rs. 10, GD entry in respective PS 27. Treasury Challan for Rs. 10, GD entry in respective PS 28. Treasury Challan for Rs. 10, GD entry in respective PS 29. Applicants are requested to attend e-Subidha Centre for the purpose of Digital Photography. Service Permanent Resident Certificate (Issued by Deputy Collector & Magistrate) Permanent Resident Certificate - For Entrance Exams /Interview/ Stay in other state or special case (Issued by Sub- Divisional Magistrate) Income Certificate ST and SC Certificate OBC Certificate - State OBC Certificate - Central Survival Certificate Next Kin Certificate Land Valuation Certificate CRC Verification for Passport/ Renewal Living Children Certificate Registration of Birth Certificate Registration of Death Certificate Distance Certificate Renewal License for Cable Operators Cinema Hall License Renewal Cinema Hall License License for Video Show Renewal License for Video Show License for Cable Operators Permission for Miking Certified Copy By Birth Citizenship Certified Copy of SC Certificate Certified Copy of ST Certificate Certified Copy By Form Citizenship Certified Copy OBC State Certified Copy Registration of Birth Certified Copy Registration of Death Certified Copy Survival Certificate Treasury Challan for Rs. 10, GD entry in respective PS 30. Certified copy of ROR Treasury Challan for Rs. 10, GD entry in respective PS 31. Certified Copy of other documents Treasury Challan for Rs. 10, GD entry in respective PS