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Amma Two Wheeler Scheme Application Form 2017-18: Urban
Amma Two Wheeler Scheme Application Form 2017-18: Urban
Amma Two Wheeler Scheme Application Form 2017-18: Urban
6 Sex(Women/Transgender)
12 Religion Hindu/Christian/Muslim/
Others(Please specify)
13 Community SC/ST/BC/MBC/OC(Please specify
the sub caste)
14 Educational Qualification
15 Occupation
(Private/Govt. aided organisation or
project/CBOs/shop
establishment/Domestic help/self-
employed/Banking correspondent /ASHA
workers) Please specify
16 a)Name and Address of the workplace
if yes, Specify.
A) women headed households
B) deserted women
C) Differently abled persons Yes/No
E) Destitute Widow
F) Unmarried women aged above 35
years
G) Scheduled Caste / Tribes
H) Transgender
I) Residing in Hilly region /remote place
24 Copy of Documents to be enclosed
a Aadhar card
b Driving License / LLR (Learner License
Registration)
c Community Certificate (in case of SC/ST)
Declaration:
1. I declare that all the information & documents submitted by me are true to the
best of my knowledge
2. I voluntarily agree to share my Aadhar number for availing the subsidy given by
the government for the purchase of Auto geared / Non-geared motorised Two
Wheeler.
3. I declare that I have a full-fledged Two Wheeler Driving license on the date of
submitting this application.
(or)
If I applied with a Learner License Registration, I shall produce the full-fledged
driving incense at the time of claiming the subsidy.
Date :
The following (ticked √) documents were NOT SUBMITTED and must be provided
during field verification. Else, your application is liable to be rejected.
o Community Certificate
(incase of SC/ST) o ID Card from Organisation, if
available