Common Application Form to be used in e-Suvidha Centres in the State of Tripura

 

 

 

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                                             Dated:

To

The Sub-Divisional Magistrate, _________________________________________

 

Sub: Prayer for  ________________________________________________________

 

Sir,

 

I would like to avail of the aforesaid Service from your Office. My personal details are as under:

 

1. Applicant Name  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Father’s / Husband’s Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Guardian Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. Relationship with Guardian: Son/ Daughter/ Wife/Husband/Brother/ Sister/ Other_______________________

 

5.

Address

Village

Road/ Lane

Post Office

Police Station

 

Communication

 

 

 

 

 

 

 

Permanent

 

 

 

 

 

 

 

 

 

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/

 

 

 

 

6. Date of Birth:  

 

7. Religion: Hindu/ Muslim/Christian/ Others________________________________________________________

 

8. Caste:  General/ST/SC/OBC/ Religious Minority               9. Community  ______________________________

 

10. Qualification: Illiterate/CEC/ Class V/Class X/Secondary/Higher Secondary/Graduate/Post Graduate and above.

 

The list of supporting documents in support of my request is as under:

 

Sl.

Supporting Document Name

Reference

Issuing Office

No.

Date

 

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8.

 

 

 

 

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10.

 

 

 

 

11.

 

 

 

 

12.

 

 

 

 

13.

 

 

 

 

14.

 

 

 

 

Thanking you.                                                                                                    Yours faithfully

 

 

              (Signature of the Applicant)

 

For Official Use Only

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­Tehsildar’s Remark:

 

           

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Revenue Inspector’s Remark:

__________________________________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DCM’s Remark:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicants are requested to attend e-Subidha Centre for the purpose of Digital Photography.

In case the Applicant is represented, one passport size photograph of the applicant should be brought along.

 

Sl No

Service

Documents Required

1.        

Citizenship Certificate

Class –I to V School Certificate, Parent Citizenship, Land Documents, Ration Card, Permanent Resident  & Born and Brought up certificate from Gazetted officer/MLA/Commissioner, Panchayat ROR, In Case applicant is minor declaration of father, Tehsil enquiry, Photo

2.        

Permanent Resident Certificate (Issued by Deputy Collector & Magistrate)

Citizenship Certificate, Ration Card, Land Documents/AMC Documents, Tehsil Enquiry and School Certificate.

3.        

Permanent Resident Certificate – For Entrance Exams /Interview/ Stay in other state or special case (Issued by Sub- Divisional Magistrate)

Citizenship Certificate, Ration Card, Tehsil Enquiry, Land Document and (School Certificate showing 10 yrs continuation stay in Tripura/ Certificate of parents showing 10 yrs continuation stay in Tripura for NERIST Entrance Examination) / (School Certificate from Class I to XII for Joint Entrance Examination)

4.        

Income Certificate

Self Declaration of Income, CRC, Ration Card, DDO Certificate, Gazetted Officers Certificate, Tehsil Enquiry, Land Document

5.        

ST and SC Certificate

Citizenship Certificate, Community certificate, Family Ration Card, ST Certificate of Father/Brother/Sister, Blood Relation Certificate, Tehsil enquiry, School Certificate, Land Document, Photo

6.        

OBC Certificate - State

Prescribed Application Form (Annexure-2), Citizenship certificate, PRC, Income certificate (MLA/Commissioner/Gazetted officer), Community Certificate, Tehsil Enquiry, Land Document, Photo

7.        

OBC Certificate - Central

Prescribed Application Form (Annexure-2), Citizenship certificate, PRC & Income Certificate from Deputy Collector & Magistrate, Community Certificate, Tehsil Enquiry, Advertisement of Central Govt. against post, Land Document, Central Document, Qualification Document, Photo

8.        

Survival Certificate

Death Certificate, Family Ration Card after deleting the name of deceased, Affidavit from Judicial Magistrate by Applicant showing survivors, Land Documents, AMC Documents, Certificate from Gazetted officer showing survivors, Panchayat ROR, Tehsil enquiry, Land Document

9.        

Next Kin Certificate

SP (DIB) Report, CRC, Ration Card, An Affidavit from Judicial Magistrate, Enquiry Report from Deputy Collector & Magistrate.

10.    

Land Valuation Certificate

Certified Copy of ROR, Tehsil enquiry

11.    

CRC Verification for Passport/ Renewal

Documents to be sent by Political Department (Home Affairs)

12.    

Living Children Certificate

PRC of Husband  & Wife, Age proof of Husband & Wife, Citizenship certificate of Husband & Wife, Sterilization Certificate and Coupon, Birth Certificate of Children, Age proof of applicant, Undertaking in original, Department Cerificates (Employees), and Tehsil Enquiry.

13.    

Registration of Birth Certificate

Citizenship of either of Parents, Certificate of Pradhan, Certificate of Doctor, Tehshil enquiry (In case delayed registration an affidavit from judicial magistrate showing date of birth and place of birth)

14.    

Registration of Death Certificate

Citizenship certificates of Deceased /parents, Certificate of Pradhan, Certificate of Doctor, Tehshil enquiry (In case delayed registration an affidavit from judicial magistrate showing date of birth and place of birth)

15.    

Distance Certificate

Fee Card, School certificate, CRC, Gazetted officer/ MLA/ Pradhan Certificate, Ration Card, Panchayat ROR

16.    

Renewal License for Cable Operators

Copy of Existing License

17.    

Cinema Hall License

Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness

18.    

Renewal Cinema Hall License

Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness

19.    

License for Video Show

Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness

20.    

Renewal License for Video Show

Police enquiry report, Fire Service Report, Electricity fitness, Construction Fitness

21.    

License for Cable Operators

Treasury Challan for Rs. 1000

22.    

Permission for Miking

Enquiry Report from Police

23.    

Certified Copy By Birth Citizenship

Treasury Challan for Rs. 10, GD entry in respective PS

24.    

Certified Copy of SC Certificate

Treasury Challan for Rs. 10, GD entry in respective PS

25.    

Certified Copy of ST Certificate

Treasury Challan for Rs. 10, GD entry in respective PS

26.    

Certified Copy By Form Citizenship

Treasury Challan for Rs. 10, GD entry in respective PS

27.    

Certified Copy OBC State

Treasury Challan for Rs. 10, GD entry in respective PS

28.    

Certified Copy Registration of Birth

Treasury Challan for Rs. 10, GD entry in respective PS

29.    

Certified Copy Registration of Death

Treasury Challan for Rs. 10, GD entry in respective PS

30.    

Certified Copy Survival Certificate

Treasury Challan for Rs. 10, GD entry in respective PS

31.    

Certified copy of ROR

Treasury Challan for Rs. 10, GD entry in respective PS

32.    

Certified Copy of other documents

Treasury Challan for Rs. 10, GD entry in respective PS