APPLICATION FORM FOR WIDOW PENSION

APPLICATION FORM FOR WIDOW PENSION
PASSPORT SIZE PHOTOGRAPH TO
BE
PASTED HERE
1.NAME OF THE APPLICANT :
2 HUSBAND’S NAME
3. FULL RESIDENTIAL ADDRESS:
4. SINCE HOW LONG RESIDENT
OF ANDHRA PRADESH
5.AGE OF APPLICANT
6.WHETHER APPLICANT IS HAVING
ANY RELATIVES GIVE
THEIR DETAILS
7.WHETHER APPLICANT HAS ANY
OTHER SOURCES OF INCOME
8. MARKS OF IDENTIFICATION :
1. ------------------------------------------
2. ------------------------------------------
I ------------------------------------------------------W/o ------------------------- do hereby state what is stated above is true and correct to the best of my knowledge and belief. Hence certified on this the --------------------------- day of -----------------------------2001
PLACE :
DATE:
SIGNATURE OR THUMB IMPRESSION OF
THE APPLICANT
For office use
HENCE RECOMMENDED/NOT RECOMMENDED.