Scribd Logo
Upload

Welcome to Scribd!

  • Agrahara Gold Silver Reg Form-E

    Uploaded by

    Haneef Mohamed
    1K views1 page
    The document is an application form for a new insurance scheme introduced by the National Insurance Trust Fund Board. It requests the applicant's personal details such as name, address, identity card number, current post, contact information, and ministry or department. It also asks the applicant to select the insurance scheme they wish to join, either the Silver Scheme or Gold Scheme. The form must be signed and recommended by the head of the applicant's institution.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    The document is an application form for a new insurance scheme introduced by the National Insurance Trust Fund Board. It requests the applicant's personal details such as name, address, identity card number, current post, contact information, and ministry or department. It also asks the applicant to select the insurance scheme they wish to join, either the Silver Scheme or Gold Scheme. The form must be signed and recommended by the head of the applicant's institution.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    1K views1 page

    Agrahara Gold Silver Reg Form-E

    Uploaded by

    Haneef Mohamed
    The document is an application form for a new insurance scheme introduced by the National Insurance Trust Fund Board. It requests the applicant's personal details such as name, address, identity card number, current post, contact information, and ministry or department. It also asks the applicant to select the insurance scheme they wish to join, either the Silver Scheme or Gold Scheme. The form must be signed and recommended by the head of the applicant's institution.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Membership No.

    (For office Use only)


    National Insurance Trust Fund Board
    Application Form to apply for the New Insurance Scheme introduced as per Public
    Administration Circular 12/2005(VI)

    01. Full name with Surname :-…………………………………………………………….......

    02. Private Address :- …………….............................................................................................

    03. National Identity Card No:-………………………………………………………………...

    04. Current Post :-…………………………………………………………………...........

    05. Telephone No of the Contributor: - Mobile:………………… Office :………………...

    06. Name of the Ministry/ Department/ Provincial Council :-………………………...............

    …………………………………………………………………………………………………..

    07. Office Address :-………………………………………………………………………...

    08. Present Agrahara Insurance Scheme :

    Normal Scheme Silver Scheme Gold Scheme

    09. Agrahara insurance Scheme to wish you would like to make contribution

    Silver Scheme Gold Scheme

    Recommendation of the Head of the Institution

    Name :-……………………………………………
    Post :-……………………………………………
    Signature :-……………………………………………
    (Please place the official frank)

    No.95, Chittampalam A Gardiner Mw, Col 02. E-Mail: mail@nitf.lk


    Tel: 0112-026600 Fax: 011-2323006 Website: www.nitf.lk

    You might also like