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    sammu

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    Gokul

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    © All Rights Reserved
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    sammu

    Uploaded by

    Gokul
    5 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
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    5 views2 pages

    sammu

    Uploaded by

    Gokul

    Copyright:

    © All Rights Reserved
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    of 2

    AADHAAR ENROLMENT

    FORM

    (Aadhaar Enrolment is free &


    भारतीय विशिष्ट पहचान प्राधिकरण भारत सरकार Voluntary)
    Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND
    SERVICES) ACT,2016 (Aadhaar Act)
    Submission Date : 02-12-
    Application Type : Enrolment
    2024
    Applicant Details Appointment Details

    Resident Type: RESIDENT


    Full Name: SAMYUKTA GOKUL
    Date Of 12-09-2022
    Birth/Age:
    Address C/O Gokul M L Manickavachagam, 45-
    C, Gokulam Apartment/ Vimal Nagar,
    Vadavalli, Vadavalli, Ahmadabad City,
    Manekbag, Ahmedabad , Gujarat,
    380015
    Email [email protected]
    Gender: Female Appointment Id: 1733126822814
    Documents to Carry: Aadhaar Seva Shop No 210 231, 2nd floor,
    Kendra Address:
    Maruti Plaza, Sardar Chowk,
    Opposite Vijay Park Society,
    Bring original documents for
    Enrolment/Update. No photocopy required. Krishna Nagar, Ahemdabad
    Original documents are scanned and given 382345
    back to you. Appointment Date
    02-12-2024 (16:10)
    Carry/Bring appointment print copy. and Time:

    Proof of identity:
    Certificate issued on UIDAI Standard Certificate format
    by: Superintendent/ Warden/ Matron/ Head of
    Institution of recognized shelter homes or orphanages
    (for children of concerned shelter home or orphanage
    only).
    Proof of date of birth:
    Certificate issued on UIDAI Standard Certificate format
    by: Superintendent/ Warden/ Matron/ Head of
    Institution of recognized shelter homes or orphanages
    (for children of concerned shelter home or orphanage
    only).
    Proof of address:
    Certificate issued on UIDAI Standard Certificate format
    by: Superintendent/ Warden/ Matron/ Head of
    Institution of recognized shelter homes or orphanages
    (for children of concerned shelter home or orphanage
    only).
    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 / I am Non Resident
    Indian (NRI) & 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 her/his name if stamp is not avaliable.)

    Note: In case of Child(< 5 Yrs) or Guardian 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.

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