AADHAAR

ENROLMENT FORM
Aadhaar Enrolment is free & Voluntary.

Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES)
ACT,2016 (Aadhaar Act)

Submission Date : 26/06/2021 Application Type : NEW ENROLMENT

Application Details Appointment Details

Full Name: armaan hussain

Gender: MALE
DOB/Age: 02-07-2009
Address: , C/O, javed abbas, b19/31,32,
devadhiyaveer, bhelupur,
bhelupur, Varanasi, Garhwasi
Tola, Varanasi, Uttar Pradesh -
221001
Mobile No.: +91-9838324037
Resident Type.: Indian Resident
Relative Name: javed abbas
Relative Aadhaar/EID: 763390559145

EA Name: HDFC BANK

Registrar Name: HDFC Bank
Appointment ID: 1624681798666
Enrolment Center Address: HDFC Bank Limited, d-58/52, A-
2A, A-5M S Plaza, Rathyatra
Crossing, Varanasi, Uttar
Pradesh,Aitha,Mahmoorganj,
Varanasi,Uttar Pradesh,221010
Appointment Date: 06/07/2021
Time Slot: 11:00 TO 11:30

Documents to Carry
1. POR: Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government bodies like Taluk,
Tehsil etc.

I hereby confirm my identity and address as being true, correct and accurate.

Guardian/Relative Name: Signature of Guardian/Relative

Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS
AND SERVICES) ACT, 2016

I confirm that I have been residing in India for at least 182 days in the preceding 12 months & information (including biometrics)
provided by me to the UIDAI is my own and is true, correct and accurate. I am aware that my information including biometrics will be
used for generation of Aadhaar and authentication. I understand that my identity information (except core biometric) may be provided
to an agency only with my consent during authentication or as per the provisions of the Aadhaar Act. I have a right to access my
identity information (except core biometrics) following the procedure laid down by UIDAI.

Verifier's Stamp and Signature: Applicant's signature/Thumbprint

(Verifier must put his/her Name, if stamp is not available)
Note: In case of Child(< 5Yrs) or Guardian/Relative based application, Guardian/Relative will be required to accompany the applicant. In case of
incapacitated person, the signature will be done by Legal Guardian of Incapacitated Person

Instructions

Please reach 15 min early at Aadhaar Seva Kendra and carry printed copy of this Application Form.
Do not damage the QR Code by folding the Application form across it.
Carry all the Document(s) selected while filling up the form.
Get the printed copy of final application form before leaving the center. Also, please fill the feedback form at the exit counter to
serve you better next time.

List of POI Documents

1. Address Card having Name and Photo issued by

Department of Post
2. Arms License
3. Bank Pass Book having name and photo
4. Bhamashah Card
5. Certificate from Superintendent/ Warden/ Matron/ Head of
Institution of recognized shelter homes for orphanages,
homes etc on their official letter head
6. Certificate of Identity containing name and photo issued
by Recognized Educational Institution signed by Head of
Institute
7. Certificate of Identity having photo issued by Gazetted
Officer or Tehsildar on letterhead
8. Certificate of Identity having photo issued by village
panchayat head or mukhiya or its equivalent authority (for
rural areas)
9. CGHS / ECHS Photo Card
10. Disability ID Card/handicapped medical certificate issued
by the respective State/UT Governments/Administrations
11. Driving License
12. Extract of School Records issued by Head of School
containing name and photo
13. Freedom Fighter Photo Card
14. Gazette notification for name change (with separately
affixed photo)
15. Government Photo ID Cards/ service photo identity card
issued by PSU
16. Kissan Photo Passbook
17. Marriage Certificate with photo
18. NREGS Job Card
19. PAN Card
20. Passport
21. Pensioner Photo Card
22. Photo Bank ATM Card
23. Photo Credit Card
24. Photo ID issued by Recognized Educational Institution
25. Ration/ PDS Photo Card
26. RSBY Card
27. School Leaving Certificate (SLC) / School Transfer
Certificate (TC), containing name and photo
28. SSLC book having candidates photo
29. ST/ SC/ OBC Certificate with photo
30. test
31. Voter ID

List of POA Documents

 List of POR Documents
1. Address Card having Photo issued by Department of Post
2. Allotment letter of accommodation issued by Central/State 1. Address card having name and photo issued by
Govt. (not more than 3 years old) Department of Post
3. Arms License 2. Any other Central/State government issued family
4. Bank Statement/Passbook entitlement document.
5. Bhamashah card 3. Army Canteen Card
6. Caste and Domicile Certificate having Photo issued by 4. Bhamashah card
State Govt. 5. Birth Certificate issued by Registrar of Birth, Municipal
7. Certificate from Superintendent/ Warden/ Matron/ Head of Corporation and other notified local government bodies like
Institution of recognized shelter homes for orphanages Taluk, Tehsil etc.
etc. on letter head 6. Certificate of ldentity having photo and relationship with
8. Certificate of Address having photo issued by MP or MLA HOF issued by village panchayat head or mukhiya or its
or MLC or Gazetted Officer or Tehsildar on letterhead equivalent authority (for rural areas)
9. Certificate of address having photo issued by Municipal 7. Certificate of ldentity having photo issued by MP or MLA or
Councilor on letterhead MLC or Municipal Councilor or Gazette Officer on
10. Certificate of Address issued by Village Panchayat head letterhead
or its equivalent authority (for rural areas) 8. CGHS/State Government/ECHS/ESIC Medical card
11. Certificate of Identity containing Name, Address and 9. Discharge card/ slip issued by Government hospitals for
Photo issued by Recognized Educational Institution birth of a child
signed by Head of Institute 10. Marriage Certificate issued by the government
12. CGHS/ECHS Card 11. NREGS Job Card
13. Credit Card Statement (not older than 3 months) 12. Passport
14. Disability ID Card/handicapped medical certificate issued 13. PDS Card
by the respective State/UT Governments/Administrations 14. Pension Card
15. Driving License
16. Electricity Bill (not older than 3 months) List of DOB Documents
17. Extract of School Records containing Name, Address and
Photo issued by Head of School 1. Birth Certificate
18. Freedom Fighter Card 2. Central Government Health Service Scheme Photo Card
19. Gas Connection Bill (not older than 3 months) or Ex-Servicemen Contributory Health Scheme Photo card.
20. Government Photo ID cards/ service photo identity card 3. Central/State Pension Payment Order
issued by PSU 4. Certificate of Date of Birth issued by Group A Gazetted
21. Income Tax Assessment Order Officer on Letterhead
22. Insurance Policy 5. Certificate of Identity containing Name, DOB and Photo
23. Kissan Passbook issued by Recognized Educational Institution signed by
24. ldentity Card issued by recognized educational institutions Head of Institute
25. Marriage Certificate Issued by the Govt, containing name 6. Extract of School Records issued by Head of School
and address containing Name, Date of Birth and Photo
26. NREGS Job Card 7. Government issued certificate (or card) having photo and
27. Passport duly signed by the signing authority
28. Passport of Parents (in case of Minor) 8. Government Photo ID Card/ Photo Identity Card issued by
29. Passport of Spouse PSU containing DOB
30. Pensioner Card 9. Mark sheet issued by any Government Board or
31. Post Office Account Statement/Passbook Recognized University
32. Property Tax Receipt (not older than 1 year) 10. PAN Card
33. Ration Card 11. Passport
34. Registered Sale/Registered Lease/Registered Rent
Agreement 12. Photo ID having Date of Birth issued by Recognized
35. School ldentity Card Educational Institution
36. School Leaving Certificate (SLC) / School Transfer 13. School Leaving Certificate (SLC)/School Transfer
Certificate (TC), containing Name and Address Certificate (TC), containing Name and Date of Birth
37. Signed Letter having Photo from Bank on letterhead 14. SSLC Book/Certificate
38. Signed Letter having Photo issued by Recognized
Educational Institution on letterhead or Photo ID having
address issued by Recognized Educational Institution.
39. Signed Letter having Photo issued by registered Company
on letterhead
40. SSLC book having photo
41. Telephone Landline Bill (not older than 3 months)
42. Vehicle Registration Certificate
43. Voter ID
44. Water bill (not older than 3 months)