8/21/2020 910000375328240171 - Registration Successful - Registration for Inter-District Movement with-in Uttarakhand

REGISTRATION FOR INTER-DISTRICT

MOVEMENT WITH-IN UTTARAKHAND

Thank You
Your ePass application for Movement with-in districts in Uttarakhand is now registered successfully. Status of
Application is - APPROVED.

Applied on: 21-08-2020

Dear SARAS AGARWAL,

This pass is not valid for people travelling from abroad. Separate instructions has been
issued by GOI

ePass application for Movement with-in districts in Uttarakhand only is registered successfully. Treat
this as APPROVAL for movement within green/orange districts in Uttarakhand only as per terms
conditions given below. Your Application No. is 910000375328240171. Journey is valid from 23-08-
2020 upto 23-08-2020 by OWN VEHICLE NO. - UK 17 E 7436, Pass Category: FAMILY /
PERSONAL REASON (SHORT VISIT UPTO 7DAYS) - FAMILY / RELATIVE MEET

FAMILY
SR. MOBILE
MEMBER FROM PLACE TO PLACE GENDER AGE
NO. NO.
NAME

PAURI
SARAS HARIDWAR/HARIDWAR/UPPER GARHWAL//SHRI
1. MALE 31 7381941031
AGARWAL ROAD, HARIDWAR SIDHBALI DHAM
MANDIR, KOTDWARA

PAURI
PRAKHAR HARIDWAR/HARIDWAR/UPPER GARHWAL//SHRI
2. MALE 24 7042646524
AGARWAL ROAD, HARIDWAR SIDHBALI DHAM
MANDIR, KOTDWARA

PAURI
KOPAL HARIDWAR/HARIDWAR/UPPER GARHWAL//SHRI
3. MALE 19 8527834524
AGARWAL ROAD, HARIDWAR SIDHBALI DHAM
MANDIR, KOTDWARA

PAURI
MADHU HARIDWAR/HARIDWAR/UPPER GARHWAL//SHRI
4. FEMALE 49 9837240524
AGARWAL ROAD, HARIDWAR SIDHBALI DHAM
MANDIR, KOTDWARA

Note: Traveller from following category/location have to follow the instructions of the state
Government. If fail he/she might be punish under the disaster act.
1. ORIGIN FROM NON HIGH-LOAD COVID INFECTED CITIES.
2. TRAVELING BY FLIGHT & TRANSITING THROUGH HIGH LOAD COVID INFECTED CITIES.
3. LEISURE TRAVELLER (FROM NON HIGH-LOAD COVID AFFECTED CITIES).

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8/21/2020 910000375328240171 - Registration Successful - Registration for Inter-District Movement with-in Uttarakhand

Terms & Conditions you agreed on

I declare that the information provided by me is accurate and to the best of my knowledge.

I confirm that I and Other traveller mentioned in form are not diagnosed with Coronovirus (COVID-
19) in last 2 months.

If information is found false action may be taken in Epidemic act or disaster management act.

The Applicant is not from containment zone in his/her City/ District

I solemnly confirm that, I and Other traveller mentioned in form don't have any symptoms of
Flu/Fever.

I solemnly confirm that, I and Other traveller mentioned in form didn't travel to other state in last
14 days.

Authorized Signatory,
District Administration, GOVT OF UTTARAKHAND

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