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01f01000301010101010101010100000000000001020304

AADHAAR ENROLMENT / CORRECTION FORM

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91a262728292a35363738393a434445464748
Aadhaar Enrolment is free and voluntary. Correction within 96 hours of
enrolment is also free. No charges are applicable for Form and Aadhaar

Enrolment. In case of Correction provide your EID, Name and only that field
which needs Correction.
In case of Correction provide your EID No here: | | | | | | | | | | | | | | |
dd |mm| yyyy|hh: mm: ss|

Please follow the instructions overleaf while filling up the form. Use
capital letters only.
1
Pre-Enrolment ID :
3
4

Full Name
Gender:
Male ( ) Female ( )
Transgender ( )

Address:
House No/ Bldg./Apt.
Landmark
Village/Town/City

District

Sub-Distr

E Mail

Mobile No

Details of

For children b
if they cannot

Name

EID/ Aadh
8

I have no objection to the UIDAI sharin

provided by me to the UIDAI with age
delivery of welfare services.
9
Select On
Enrolmen
Iw
linked to
A
purpose
Ih
Aadhaar
St
IF
Verification Type : Document Based ( ) Introducer Based ( ) Head of Family ( )
Select only one of the above. Select Introducer or Head of Family only if you do not possess an
Family details are not required in case of Document based Verification.
10
For Docu

valid docume

a. POI

b. POA

c. DOB
(Mandatory in case of Verified Date of Birth)

11

d. POR

For Introducer Based Introducers

Aadhaar No. | | | | | | | | | | | | |

I hereby confirm the identity and address of ______________________________as being true, correc
Introducer/HoFs Name:

Consent

Signature o

I confirm that information (including biometrics) provided by me to the UIDAI and the informati

ffd8ffe000104a4649460001020100dc00dc0000ffe20c584943435f505
24f46494c4500010100000c484c696e6f021000006d6e747252474220
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000d32d4850202000000000000000000000000000000000000000000
00000000000000000000000000000000000000000000000000000116
3707274000001500000003364657363000001840000006c777470740
00001f000000014626b707400000204000000147258595a0000021800
0000146758595a0000022c000000146258595a000002400000001464
6d6e640000025400000070646d6464000002c4000000887675656400
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043c0000080c7465787400000000436f7079726967687420286329203
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322e3100000000000000000000000000000000000000000000000000
0000
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000
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000
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22e31000000000000000000000000000000000000000000000000000

000
Verifiers Stamp and Signature:
(Verifier must put his/her Name, if stamp is not available)
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------To be filled by the Enrolment Agency only : Date &
time of Enrolment: ___________________________________

Instructions to follow while filling up the enrolment form

Field 2
NPR NUMBER

Resident may bring his/her National Population Register

Survey slip (if available) and fill up the column.

Field 3
NAME

Write full name without salutations/titles. Please bring the

original* Proof of Identity (POI) document. (See list A below).
Variation in Residents Name in contrast to PoI is permissible
as long as the change is minor spelling only, without altering
the Name in PoI document. For Example: If Residents PoI
reads Preeti, then Priti can be recorded if Resident wants
so.
Fill in Date of Birth in DDMMYYYY format. If exact Date of Birth
is not known, approximate age in Years may be filled in the
space provided. Please bring the original Proof of Date of Birth
(DoB), if available.(See list D below). Declared checkbox may
be selected if Resident does not have a valid proof of Date of
Birth document. Verified checkbox is selected where Resident
has provided documents as proof of Date of birth.
Write complete address. Please bring the original Proof of
Address (POA) document. (See list B below). Please note that
the Aadhaar letter will be delivered at the given address only.
To include Parent / Guardian / Spouse name as part of the
address, select the appropriate box and enter the name of the
person.
Minor Corrections / Enhancements are permissible to make
the address complete without altering the base address as
mentioned in the POA document.

Field 5
DOB / AGE

Field 6
ADDRESS

Field 7
RELATIONSHIP

Field 8
CONSENT
Field 9
BANK ACCOUNT
Field 10
DOCUMENTS

Field 11
INTRODUCER/HoF

In case of children below 5 years, it is mandatory to provide

father/mother/guardian details with their Aadhaar or EID
number.
If the resident is not holding a Proof of Identity & using the
Head of the Family identity for enrolment, it is mandatory to
provide Head of the familys details with his/her Aadhaar or
EID number. Please refer illustration below for filling EID.
Please bring the original Proof of Relationship (POR)
document. (See list C below).
For other cases, it is optional for the resident to fill up the
relationship details.
Resident may specifically express willingness / unwillingness
by selecting the relevant box.
Resident may choose to open a new Aadhaar enabled bank /
POSB account or can link existing bank account to Aadhaar
number. Relevant details as requested may be provided. This
is an optional field.
Write the name of Documents for PoI and PoA. In case proof of
Date of Birth is available, then write the name of Date of Birth
document. If the resident is not holding a Proof of Identity &
using the Head of Family based enrolment, then write the
name of Proof of Relationship document. For Valid list of
documents, please refer list of Documents below.
Resident who does not have POI and POA may get enrolled
through an Introducer/ Head of Family. Pl contact nearest
enrolment centre or your Registrar, for further details.

List A. POI documents

1. Passport
2. PAN Card
3. Ration/ PDS Photo Card
4. Voter ID
5. Driving License
6. Government Photo ID Cards/ service
photo
identity card issued by PSU
7. NREGS Job Card
8. Photo ID issued by Recognized
Educational Institution
9. Arms License
10. Photo Bank ATM Card
11. Photo Credit Card
12. Pensioner Photo Card
13. Freedom Fighter Photo Card
14. Kissan Photo Passbook
15. CGHS / ECHS Photo Card
16. Address Card having Name and
Photo
issued by Department of Posts
17. Certificate of Identify having photo
issued by
Gazetted Officer or Tehsildar on
letterhead
18. Disability ID Card/handicapped
medical
certificate issued by the respective
State/UT
Governments/Administrations

List B. POA documents

1. Passport
2. Bank Statement/ Passbook
3. Post Office Account Statement/Passbook
4. Ration Card
5. Voter ID
6. Driving License
7. Government Photo ID cards/ service
photo identity card issued by PSU
8. Electricity Bill (not older than 3 months)
9. Water bill (not older than 3 months)
10. Telephone Landline Bill (not older than
3 months)
11. Property Tax Receipt (not older than 3
months)
12. Credit Card Statement (not older than
3 months)
13. Insurance Policy
14
14. Signed Letter having Photo
from Bank on
letterhead
15. Signed Letter having Photo issued by
registered Company on letterhead
16. Signed Letter having Photo issued by
Recognized Educational Instruction on
letterhead
17. NREGS Job Card
18. Arms License
19. Pensioner Card
20. Freedom Fighter Card

List C. POR documents

Illustration for filling up EID No.

21. Kissan Passbook

22. CGHS / ECHS Card
23. Certificate of Address having photo
issued by
MP or MLA or Gazetted Officer or
Tehsildar on
letterhead
24. Certificate of Address issued by
Village Panchayat head
or its equivalent authority (for rural
areas)
25. Income Tax Assessment Order
26. Vehicle Registration Certificate
27. Registered Sale / Lease / Rent
Agreement
28. Address Card having Photo issued by
Department of
Posts
29. Caste and Domicile Certificate having
Photo issued by
State Govt.
30. Disability ID Card/handicapped
medical certificate
issued by the respective State/UT
Governments/Administrations
31. Gas Connection Bill (not older than 3
months)
32. Passport of Spouse
33. Passport of Parents(in case of Minor)

List D. DOB documents

1. PDS Card
2. MNREGA Job Card
3. CGHS/State Government/ECHS/ESIC Medical card
4. Pension Card
5. Army Canteen Card
6. Passport
7. Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government
bodies like Taluk, Tehsil etc.
8. Any other Central/State government issued family entitlement document.

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0000
1.
2.
3.
4.

Birth Certificate
SSLC Book/Certificate
Passport
Certificate of Date of Birth issued by Group A Gazetted Officer on Letterhead

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000146758595a0000022c000000146258595a0000024000000014646
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22e31000000000000000000000000000000000000000000000000000
000

*In instances where original documents are not available, copies attested / certified by a public notary /
gazetted officer will be accepted.
-------------------------------------------------------------------------------------------------------------------------------------

---------------------------------------------------------------