APPLICATION FORM Senior Citizen Identity Card

APPLICATION form . Senior Citizen Identity Card Fields marked with (*) are mandatory Applicant's Details Name*. Photograph of the person Father's/Husband's Name* ( on whose name Senior Gender* Male Female Transgender Citizen ID card is to be (DD/MM/YYYY) issued). Date of Birth*. (This photo is for scanning Mobile No.* do not cross sign). Aadhaar No. Email Height ( in cm)*. Visible Identification Mark*. Current Residence Address : House No / Flat No. * Sector / Village*. Tehsil / Sub-District* Chandigarh District* Chandigarh State/UT* Chandigarh Pin Code*. Permanent Residence Address : Same as the current address. House No / Flat No. * Sector / Village*. Tehsil / Sub-District* District*. State/UT* Pin Code*. Self-Undertaking I Son/Daughter of Sh.. aged resident of ., verify that the above contents and supporting documents are correct to the best of my knowledge Photograph of the person and belief and nothing has been concealed therein.

School leaving certificate / Secondary School leaving certificate/ Certificate of Recognized Boards from the school last attended by the applicant or any other recognized educational institution Passport Affidavit sworn before a magistrate stating the -literate(Below Class 5) Pan Card Age assessment certificate from PMO Sector-

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  Form, Applications, Senior, Certificate, Identity, Citizens, Secondary, Application form senior citizen identity

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