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    Application For Correction(s) in Digital Ration Card

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    Subdey
    1) Existing card type and number of head of family or other member. 2) New address details if address needs correcting. 3) Contact details. 4) Other details needing correction such as name, date of birth, card category. 5) Aadhaar details of all card holders. The applicant must sign agreeing the inputs are true, and submit documents like Aadhaar cards and proof of identity or address if correcting those details.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Application For Correction(s) in Digital Ration Card

    Uploaded by

    Subdey
    721 views2 pages
    1) Existing card type and number of head of family or other member. 2) New address details if address needs correcting. 3) Contact details. 4) Other details needing correction such as name, date of birth, card category. 5) Aadhaar details of all card holders. The applicant must sign agreeing the inputs are true, and submit documents like Aadhaar cards and proof of identity or address if correcting those details.

    Original Description:

    From fill-up 5 From fill-up 5 From fill-up 5 From fill-up 5

    Original Title

    Form 5

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    1) Existing card type and number of head of family or other member. 2) New address details if address needs correcting. 3) Contact details. 4) Other details needing correction such as name, date of birth, card category. 5) Aadhaar details of all card holders. The applicant must sign agreeing the inputs are true, and submit documents like Aadhaar cards and proof of identity or address if correcting those details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    721 views2 pages

    Application For Correction(s) in Digital Ration Card

    Uploaded by

    Subdey
    1) Existing card type and number of head of family or other member. 2) New address details if address needs correcting. 3) Contact details. 4) Other details needing correction such as name, date of birth, card category. 5) Aadhaar details of all card holders. The applicant must sign agreeing the inputs are true, and submit documents like Aadhaar cards and proof of identity or address if correcting those details.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Form 5

    Application for correction(s) in Digital Ration Card


    ( নাম , ঠিকানা,বয়স ইত্যাদি সংশ াধশনর আশবিন
    (Please use this form to make necessary changes in your existing Digital Ration Cards)
    (* marked field are compulsory)
    Section A: Existing Card type and number of the Head of Family (HoF)/Any other member
    Name*

    Ration Card Type* AAY PHH SPHH RKSY-I RKSY-II GEN

    Ration Card Number*


    Section B: New Address details
    (If you want to change your ADDRESS)
    District*
    Sub-division*
    Block/Municipality/ Municipal
    Corporation*
    Gram Panchayat/ Ward No*
    Village/Road/ Street *
    Pin Code*
    Post Office*
    Police Station
    Section C: Contact details of the family
    Primary Mobile Number*(For communication)
    Secondary Mobile Number
    Whatsapp Number
    Email ID (if any)
    If you don’t want us to send e-bill and other important messages, tick the box

    Section D: Other details on which you need correction


    (Please provide the correct details of only that prection)
    Name of Member 1

    Father’s/Husband
    Name*
    Date of Birth* D D M M Y Y Y Y
    Digital Ration Card No.*
    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Whether Person with Disability (PWD) Yes No
    Name of Member 2*

    Father’s/ Husband Name*

    Date of Birth* D D M M Y Y Y Y
    Digital Ration Card No.*
    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Whether Person with Disability (PWD) Yes No

    You may also apply online. Visit www.wbpds.gov.in


    E: Aadhaar Details of all existing DRC holders of the family* (Form will not accepted if Aadhaar number is not given)
    Name of Member 1
    (Head of Family)*

    Digital Ration Card No.*


    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Aadhaar number* (attach copy)
    Whether Person with Disability (PWD) Yes No
    Name of Member 2

    Digital Ration Card No.*


    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Aadhaar number* (attach copy)
    Whether Person with Disability (PWD) Yes No
    Name of Member 3

    Digital Ration Card No.*


    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Aadhaar number* (attach copy)
    Whether Person with Disability (PWD) Yes No
    Name of Member 4

    Digital Ration Card No.*


    Card Category* AAY PHH SPHH RKSY-I RKSY-II GEN
    Aadhaar number* (attach copy)
    Whether Person with Disability (PWD) Yes No

    [ ] I agree that all inputs given above are true to the best of my knowledge. I agree that the application may be rejected, or the Ration Card if issued,
    may be cancelled if any information furnished here is found to be false. I also acknowledge that other legal action may be taken against me for
    furnishing wrong information or hiding any relevant information, either at the time of application or at later stage.

    4Date: Signature /LTI of the applicant

    Checklist of documents:
    1.Copy of Aadhaar documents of all family members and applicants
    2.If the age of the applicant is less than 5 years, then copy of Aadhaar card is not mandatory. In that case copy of birth certificate of such
    applicant is to be submitted for personal details
    3.Copy of EPIC/KCC/Bank Passbook/Driving licence/Passport for correction of name and/or address
    4.Photocopy of existing DRC

    ___________________________________________________Receipt_______________________________________________________

    Received Application vide Barcode Number______________________________________________ for Form _________

    Date………………… Signature and seal

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