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PROFORMA-D

STATEMENT SHOWING THE PARTICULARS OF NAVASAKAM RICE CARDS NOT DISTRIBUTION REASON-WISE
Total No. of No. of NSRCs not distributed due to
S.NO. NAME OF THE MANDAL NSRCs cannot be Perma nent
distributed Death Duplicates Bogus Others (specify)
Migration

RAYACHOTY ULB NOT TRACED :7


1 KOTHAPETA STREET SECRETARIAT : 17 1 8 GOVT
1121019 PENSIONER :1

10

11

12
WISE

Remarks
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Address Mob no Old Ration card no New Ration Card no Reason (Death/ Remarks
Card holder family Permanent
Migration/
Duplicate/ Bogus/
others -specify)

SHE BELONGS TO
BELONGS KOTHAPALLI-2
1 Shaik Zaharabi KOTHAPALLI-2 BOTH 2 PERSONS SECRETARIAT
7893043975 YAP118300800271 2801627423
DIED BOUNDARIES
SECRETARIAT

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no New Ration Card
of Card holder no
family

2 Shaik Kadirun 9966379551 WAP1183013B0402 2802029070


forma - D
e Cards – Reason Details

Reason (Death/ Permanent Remarks


Migration/ Duplicate/ Bogus/
others -specify)

NOT TRACED AND NON DRAWN RICE

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Address Mob no Old Ration card New Ration Card no
Card holder no
family

Pottigari
Venkata JAP113101
3 Subbamma 9703981598 2803526382
000069
D
– Reason Details

Reason (Death/ Permanent Remarks


Migration/ Duplicate/ Bogus/
others -specify)

PERSONS SHIFTED TO
PRODDUTUR AND RICE
DRAWN AT PRODDUTUR
SHOP:1182019

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no New Ration Card no
of Card holder
family

Barinepalli
4 9052074971 WAP114700100353 2805454916
Manjula
D
Reason Details

Reason (Death/ Permanent Remarks


Migration/ Duplicate/ Bogus/
others -specify)

PERSONS SHIFTED TO SAMBEPALLI


AND RICE DRAWN AT SHOP NO
1147004

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Address Mob no Old Ration card no New Ration Card
Card holder family no

Asif 9494884651 RAP114900501203 2805536522


5

Signature of Volu
Reason (Death/ Remarks
Permanent
Migration/
Duplicate/
Bogus/ others
-specify)

NOT TRACED
AND NON
DRAWN RICE

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Card Address Mob no Old Ration card no
holder family

Nandaluri Anuradha NOT WORKING WAP1183013C017


6
6
D
Reason Details

New Ration Card no Reason (Death/ Remarks


Permanent
Migration/
Duplicate/ Bogus/
others -specify)

2807003898 RICE NOT DRAWN


LAST 6 MONTHS

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no
of Card holder
family

Budde
7 7386728993 WAP114801900106
Lakshmidevi
roforma - D
ice Cards – Reason Details

New Ration Card no Reason (Death/ Permanent Remarks


Migration/ Duplicate/
Bogus/ others -specify)

PERSONS SHIFTED TO
2809269197 VEERABALLI AND RICE DRAWN
AT SHOP NO 1138019

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Card holder family Address Mob no Old Ration card no

8 C.Vijaya Rama Raju 9490331551 RAP113802900066


etails

New Ration Reason (Death/ Remarks


Card no Permanent
Migration/
Duplicate/
Bogus/ others
-specify)

PERSONS SHIFTED
TO VEERABALLI
2809986586
AND RICE DRAWN
AT SHOP NO 1138029

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Card Address Mob no Old Ration card no New Ration
holder family Card no

9 Modem Uma Devi 9658686748 WAP118301500014 2810134245


son Details

Reason (Death/ Remarks


Permanent
Migration/ Duplicate/
Bogus/ others
-specify)

PERSON RICE DRAWN AT SHOP NO


1183041 BUT VOLUNTEER NOT
MAPPED

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Card Address Mob no Old Ration card no
holder family

10 NO DATA NOT KNOWN WAP1183014A0173


D
Reason Details

New Ration Card no Reason (Death/ Remarks


Permanent
Migration/
Duplicate/ Bogus/
others -specify)

RICE NOT DRAWN


2810507366 LAST 3 MONTHS AND
NOT TRACED

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no New Ration
of Card holder Card no
family

11 Pasupuleti 9989497157 WAP113502800061 2811185625


Santamma
n Details

Reason (Death/ Remarks


Permanent
Migration/
Duplicate/ Bogus/
others -specify)

RICE DRAWN AT SHOP


NO 1149026 AND WRONG
MOBILE NUMBER

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Card Address Mob no Old Ration card no New Ration
holder family Card no

12 Mandem Ademma 9533388796 YAP1183014B0287 2812308790


n Details

Reason (Death/ Remarks


Permanent
Migration/
Duplicate/
Bogus/ others
-specify)

PERSONS SHIFTED TO KODURE


AND RICE DRAWN AT SHOP NO
1143007

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no New Ration
of Card holder Card no
family

13 Appalaneni NOT KNOWN RAP114700100849 2814047501


Narayanamma
son Details

Reason (Death/ Remarks


Permanent
Migration/
Duplicate/ Bogus/
others -specify)

RICE NOT DRAWN LAST 5


MONTHS

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Address Mob no Old Ration card no New Ration Card Reason (Death/
Head of no Permanent
Card Migration/
holder Duplicate/ Bogus/
family others -specify)

14 NO DATA NOT KNOWN WAP118400800122 2815321064

Signature of Volunteer:
Remarks

RICE NOT DRAWN


LAST 5 MONTHS

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Address Mob no Old Ration card no New Ration Card
Card holder family no

15 Ranimani 8179509570 WAP113703400276 2817256900


Nagalakshmi
tails

Reason (Death/ Remarks


Permanent
Migration/ Duplicate/
Bogus/ others
-specify)

PERSONS SHIFTED TO
RAMAPURAM AND
RICE DRAWN AT SHOP
NO 1137034

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head of Address Mob no Old Ration card no New Ration Card
Card holder family no

Peddapogu 7650848574 JAP115002900120 2819242669


16
Gangulamm
a
ason Details

Reason (Death/ Remarks


Permanent Migration/
Duplicate/ Bogus/
others -specify)

NOT TRACED AND NON DRAWN


RICE

Signature of Volunteer:
Proforma - D
Undistributed Rice Cards – Reason Details
Name of Mandal: RAYACHOTY ULB
Name of Secretariat: KOTHAAPETA STREET
Secretariat ID: 1121019
Cluster ID:
Name of Volunteer:
Mob no of Volunteer:
Sl no Name of Head Address Mob no Old Ration card no New Ration
of Card holder Card no
family

Vempalli 8500472862 JAP118300800233 2819299290


16 Sethu
Ramamm
a
Details

Reason (Death/ Remarks


Permanent Migration/
Duplicate/ Bogus/
others -specify)

SURRENDOR OF RICE
CARD (GOVT
PENSIONAR)

Signature of Volunteer:

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