AADHAAR Application Form Free Download Kerala Malayalam version

1. Date:………………. AADHAAR APPLICANTION FORM Pre-Enrolment / /Form No.......................
A.ആധാര പദതികായി ( UID) േേഖരികന വിവരങള
1.Name (േപര്) :
2.Gender : Male (പരഷന) Female (സീ) Transgender(മേേെതങിലം)
3.Date of Birth : ............/......../...............
4.Mother / Father / Husband / Wife/Guardians Name :
(അമ/അചന/ഭരതാവ്/ഭാരയ/രകകരതാവ്)
5.Residential Address (േമലവിലാസം) :
House No and Name (വീടനമര / വീടേപര്) :
Landmark :
Village / City (വിേേജ് / സിേി) :
District (ജിേ) :
State (സംസാനം) :
6.Phone No / Mobile No. (Optional) (േോാണ / െമാൈൈല നമര):
7.Email (Optional) (ഇ-െമയില)
8.Introducers Name & UID (പരിചയെെടതന ആളിെെ േപരം ആധാര നമറം):
Information provided herein can be shared with agencies engaged in delivery of welfare services including financial
services. 囗 (put tick mark if the option is YES)
തനിരികന വിവരങള േകമ പവരതനങളകായള (സാമതിക സഹായം ഉളെെെെ) ഏജനസികളക്
ൈകമാറാവനതാണ്. 囗
9.Bank Name and Branch (ൈാങിെെ േപര് ബാഞ്) (നിരൈനമിേ):....................................................................
A/c No. (അകൗണ് നമര)(നിരൈനമിേ):....................................
10.15 വയസിന് താെെ പായമായ കടികളെെ അമ/അചന/രകകരതാവിെെ േപര് നിരൈനമാണ്
കടിയെെ രകിതാവിെെ േപര് :.................................................... UID/EID (നമര):................................
B േകരള സരകാരിനായി േേഖരികന വിവരങള (KYR Plus)
1. Marital Status : Single/Married/Widow 2. Category: Gen/SC/ST/OBC/OEC
3. Highest Qualification : Phd/PG/Graduate/Diploma/
IT/+2 /10 /Student/Attend 4. House Status: Own/Rented/Other
School/Not attend school
5. Handicapped (Yes / No) %............................................. 6. Occupation: Government Service/Private
Service/Business/Agriculture/Self Employed/
Daily Wage Earner/ PSU/Other
7. PEN (Yes/No) No :......................................... 8. Election ID Card No..........................................
9. Driving License Type (Yes/No): Two Wheeler/Four Wheeler/Both 10. Driving Licence No..........................................
11. PAN No (Yes/No.) : .................................................... 12. LPG Gas Connection (Yes/No)........................
13. Ration Card No. : ..................................................... 14 Employment Ex.Reg.Card No(Yes/No)............
15. NREGA Card No. (Yes/No) : ................................................... 16. Passport No. (Yes/No) No...............................
17 Chiak Insurance No. (Yes/No) No:.....................................................
Verifiers Name & signature Introducer's Name & Signature Applicants Signature