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ಸುವರ್ಣ ಕರ್ನಾಟಕ |
ಆಹಾರ,ನಾಗರಿಕ ಸರಬರಾಜು ಮತ್ತು ಗ್ರಾಹಕರ ವ್ಯವಹಾರಗಳ ಇಲಾಖೆ | ಹೊಸ ಪಡಿತರ ಚೀಟಿಗಾಗಿ ಅರ್ಜಿ |

Receipt No | 314422 | Receipt Date | 26/11/2011 | |
Place of Residence | Urban/IRA | |
District | BANGALORE | Taluk | BANGALORE SOUTH(IRA) | | City | BANGALORE IRA SOUTH | Ward No | 59 |
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Card Type Applying For | Above Poverty Line |
Do you have Electricity Connection? | Yes |
District / Taluk /ESCOM Circle Code | BANGALORE / / |
Location Code | 1120301 | R R No | 1SH19160 |
If you share electricity bill with another family, then your average monthly share in rupees | 0 |

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Name of the Applicant | G S NAGARAJA |
Residence Address
PIN | No 87/A, 31st A Cross, Yediyur, Jayanagar 7th Block, Bangalore 560082 | Office Address
PIN |
0 |
Landmark | OPP CANARA BANK | Since how many years you are residing in the address? | 22.00 | | LandLine Phone No | 0 | Mobile No | 9902977412 |
Date of Birth (dd/mm/yyyy) | 09/04/1947 | Year of Birth (yyyy) | 1947 | Gender | Male | Aadhar No | |
E - mail | | Employment | RETIRED |
Residence Type | Own | | |
Marital Status | Married |
Do you stay with your Family? | Yes |

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Other Details |
Total Income of the Family (in Rs.) | 15000 | Income Tax Pan Card No | | LPG connection is available? | Yes | Do you need LPGConnection? | No | LPG Details |
Company| Distributor| Consumer No| Consumer Name|
IOC| D K AGENCIES| 22270| Nagaraja G S|
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Reasons to Apply for Ration Card | Non Computerised Ration Card | Remarks | |

ಘೋಷಣೆ |
ನಾನು ಈ ಮೂಲಕ ಘೋಷಿಸುವುದೇನೆಂದರೆ | ಅ)ನನ್ನ ಹೆಸರಿನಲ್ಲಾಗಲೀ ಅಥವಾ ನನ್ನ ಕುಟುಂಬದ ಯಾವುದೇ ಸದಸ್ಯರ ಹೆಸರಿನಲ್ಲಾಗಲೀ ಮೇಲಿನ ವಿಳಾಸದಲ್ಲಾಗಲೀ ಅಥವಾ ಬೇರಾವುದೇ ವಿಳಾಸದಲ್ಲಾಗಲೀ ಪಡಿತರ ಚೀಟಿ ಪಡೆದಿರುವುದಿಲ್ಲ. ಈಗಿನ ವಿಳಾಸದಲ್ಲಿ  22.00  ವರ್ಷದಿಂದ ವಾಸವಾಗಿರುತ್ತೇನೆ. | ಆ)ನನ್ನ ಕುಟುಂಬದ ಯಾವುದೇ ಸದಸ್ಯರ ಹೆಸರುಗಳು ಬೇರಾವುದೇ ಪಡಿತರ...
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