Professional Documents
Culture Documents
1. Name
Stamp Size
2. Date of Birth / Age Photograph
3. Address
Religion: Caste:
5. Details of husband's Death:
(ii)
(iii)
(iv)
(v)
(vi)
(vii)
DECLARATION
I hereby declare that the above information is true to the best of my knowledge
and belief.
Place:
FOR OFFICE USE
Attributable
Non Attributable
After Retirement
Date : Signature
Secretary,
Place: DSS&A Board
with Office Stamp &
Date.