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    Pmkisansaman

    Uploaded by

    choudharyrajnish37
    pmkisansaman

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    © All Rights Reserved
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    Pmkisansaman

    Uploaded by

    choudharyrajnish37
    6 views1 page
    pmkisansaman

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    pmkisansaman

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    pmkisansaman

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    6 views1 page

    Pmkisansaman

    Uploaded by

    choudharyrajnish37
    pmkisansaman

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PRADHAN MANTRI KISAN SAMMAN NIDHI (PM - Kisan) _________

    Application Form
    Sub District:.............................Block: ..............................Village:..................................Farmer’s Name:........................................
    Government of Himachal Pradesh

    ................................................Sex: Male [M] /Female [F]/Other [T]............. Category: SC[1]/ST[2]/BC[3]/OBC[4]/Gen[5] ..........

    AADHAAR ID: IFSC Code

    Bank A/C. DD ......./...........


    Mobile:........................ D.O.B : ....../ MM YYYY

    F/H Name:............................................................ Address:..............................................................................................................

    Ownership : Single [1 ] /Joint [2 ]. Land Details: Survey/ Khata No. / Khewat No...............................................................................

    Area in Hectare:.................................Khasra No *................................................. (*More land detail, if any, may be written on back page)

    Self Declaration: Yes/ No


    I am an institutional farmer

    Any family member ever held or holding a constitutional post

    Any family member ever held or holding the post of MLA/MP/Mayor/ Chairman Zila Parishad

    Any family member is /was serving or retired employees of central / state government (excluding class 4 employees)

    Any family member is a Retd. Pensioner having a pension more than 10,000/- per month (excluding class 4 employees)

    Any family member has paid Income Tax for assessment year 2018-19

    Any family member is a registered Doctor/Lawyer/CA/Engineer/Architects practicing privately

    Permission to use AADHAAR Number:

    I .........................................................S/o.......................................R/o Village..............................................
    hereby grant my permission to use my AADHAAR number for verification purpose under ( PM-Kisan) scheme only.

    Date & Place .............................. Signature.........................................

    Declaration by the applicant:


    I....................................................S/o........................................R/o Village.......................................hereby declare
    that above information provided by me is true to my knowledge, and if found incorrect, only I would be liable for
    the same. My total cultivable land is less than 2 hectares.

    Enclosed: AADHAAR Copy— Yes/ No Bank Details Copy— Yes/ No

    Date & Place........................................................................ Signature....................................................

    Verified By Patwari Signature................................... Seal ........................................

    For Office Use


    Application Accepted: Yes/No Data Entered: Yes/No

    if No, Reason for Rejection:..................................................... Date:......................


    NIC HP

    DEO Name:...................................
    Signature ....................................... Seal .............................
    Signature:....................................

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