Transcription of application for buspass - Chandigarh Transport …
1 application for issue of Bus Pass Bus Pass for AC Non AC Photo paste here 1. Name : _____ 2. Father s Name : _____ 3. Gender : MALE FEMALE 4. Address : _____ 5. Phone/Mobile No. :_____ 6. Fare to be paid (Including Rs. 30/- Facilitation fee)_____ Category :-Student Govt. Employee General Category Senior Citizen 1. Student/Employee / Applicant Name _____ 2. Name & Address of Office/ Institution (recog.)/ Applicant _____ _____ 3. Applicant whether Private or Govt. Employee or Student_____ 4. Mention route no. here for specific bus passes_____ Signature of Applicant Mobile /Telephone No. _____ Authorised Signatory with Stamp of Organization Name : Designation: Phone No.
2 INSTRUCTIONS:- The Photo and Form both will be attested by the HOD Authorised Signatory of Department/ Institution as the case may be. Also enclose one extra photograph. Senior Citizen may submit this form along with Photo ID proof and proof of his /her age. The name, contact address with proof, Phone No. & signature of authorised signatory of recognised educational institution/govt. office should be submitted to the Traffic Branch, of CTU Plot No. 701, Industrial Area, Phase-1, Chandigarh , Ph. No. 0172-2679003. Duly filled form to be submitted at any e-Sampark Centre to get the bus pass issued. In case of general passes , the applicant shall submit his/her identification proof along with photo.
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