]] ESpfOD;oabmwl .............................................

ta&mif;t0,f p&Hay;uwdpmcsKyf}}

............................................. NrdKY? trSwf ( ) .................................................... ae?

OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifolykdifjzpfaom .............................................................................................................. ukd?
............................................. NrdKY? trSwf ( ) .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifxm;oltm; usyf ...............................^- (usyf........................................................ )wdwdjzihf
ckESpf? .............................. v? ( )&ufaehwGif ta&mif;t0,fjyKvkyf&efoabmwlMuygonf/
,aehpmcsKyfcsKyfonfUaehwGif 0,f,lolu a&mif;csoltm;p&HaiG usyf ...........................................^-
(usyf........................................................ )wdwdukd ay;xm;NyD;? usefaiG usyf ...............................^-
(usyf......................................................... )wdwdukd ( )aehwGif tajytaMu ay;acsrnf
jzpfaMumif;? 0,f,lolu0efcHygonf/ tu,fí ay;&efysufuGufcJhvQif ay;xm;onfUp&HaiG tqHk;½IH;cHrnfjzpfaMumif;
0efcHygonf/ a&mif;csoluvnf; 0,f,lolu aiGtajytaMuay;aqmifEdkifygvQuf rdrda&mif;cs&efysufuGufcJUygvQif
&,lxm;NyD;aomp&HaiGtjyif ,if;p&HaiG\ (2)qukd jyefvnfay;avQmfrnfjzpfaMumif;0efcH uwdjyKygonf/
tqdkyga&mif;csol OD;^a': ........................................onf tqdkyg ..........................................
......................................ukd rdrdykdifqkdifNyD;? taygiftEHS? tcsKyftcs,f? vHk;0uif;&Sif;aMumif;ESifU 4if;ESifUpyfvsOf;í
wpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygvQif rdrpd &dwjf zift U uketf uscí
H vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k
tykdifa&mif;csolrS 0efcHuwdjyKNyD; atmufygtodoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(a&mif;csol) (0,f,lol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl ............................................. iSm;&rf;jcif; p&Hay;uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
iSm;&rf;ol / / ................................................................................................................................

p&Hay;ol / / ................................................................................................................................

iSm;&rf;onfht&m / ................................................................................................................................

................................................................................................................................

þiSm;&rf;jcif;p&Hay;uwdpmcsKyfukd ESpfOD;oabmwlcsKyfqdkMuonfrSm -
ykdif&Sifjzpfol OD;^a': ........................................rSwfyHkwiftrSwf ............................................ u
ykdifqdkifNyD;? tusdK;cHpm;vQuf&Sdaom .................................................tm; ..........................................NrdKY?
trSwf( )? ........................vrf;? .............................&yfuGuf? rSwfyHkwiftrSwf ......................................
ukdifaqmifol? OD;^a': .........................rS wpfvvQif ....................... ^- (usyf.....................................wdwd)
jzifUESpfOD;oabmwliSm;&rf;jcif;twGuf p&HaiGay;Mujcif;jzpfygonf/
txufazmfjyygykdif&SifESifU iSm;&rf;olwdkhonf atmufygtwdkif;iSm;&rf;rnfjzpfí ,aeh( )&ufaeh
wGif iSm;&rf;olrSp&HaiGusyf ................................. ^- (usyf............................................wdwd)ukd ay;acsí
ykdif&SifrSvufcH&&Sdygonf/ usefaiGusyf ................................. ^- (usyf............................................wdwd) ukd
( )&ufaehwGif ay;acsrnfjzpfaMumif; ESpfOD;oabmwlnDMuygonf/ iSm;&rf;jcif;umvukd ( )v^ESpf
xdowfrSwfMuygonf/
tu,fí ykdif&SifbufrSiSm;&rf;&efysufuGufcJhaomf &,lxm;NyD;aomp&HaiGtjyif ,if;p&HaiG\ (2)qukd
jyefvnfay;avQmf&rnf/ iSm;&rf;olbufrSysufuGufcJhaomfp&HaiGukdtqHk;cH&rnfjzpfaMumif;0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;ukd ykdif&SifjzpfolESifUiSm;&rf;jcif;p&HaiGay;olwdkh ESpfOD;oabmwlnDMuygí
atmufygtodoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(ykdif&Sif) (iSm;&rf;jcif;p&HaiGay;ol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwltdrfta&mif;t0,f uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
............................................. NrdKY? trSwf ( )? .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifolykdifjzpfaom ....................................... NrdKY? ................................. vrf;? tdrftrSwf ( )?
tus,ft0ef; ( )ayukd
............................................. NrdKY? trSwf ( )? .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifxm;oltm; usyf ...............................^- (usyf........................................................ )wdwdjzihf
.................... ckESpf? .............................. v? ( )&ufaehwGif tNyD;tydkifa&mif;csvdkufygonf/
tqdkyga&mif;csvdkufaom .............................................................................................
.................................................................................................................................ukd a&mif;csol
OD;^a': ........................................u rdrdykdifqkdifNyD;? taygiftEHS? tcsKyftcs,f? vHk;0uif;&Sif;aMumif;ESifU
4if;ESifUpyfvsOf;í wpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l tl m;wpfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU
tuket f uscí H vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(a&mif;csol) (0,f,lol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)

1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl ajruGufta&mif;t0,f uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
a&mif;ol / / ................................................ rSwfyHkwiftrSwf ...........................................................
ae&yfvdyfpm ...............................................................................................................
0,f,lol / / ................................................ rSwfyHkwiftrSwf ............................................................
ae&yfvdyfpm ...............................................................................................................
ta&mif;t0,fjyKvkyfonfhajruGuf / ........................................................................................................
.........................................................................................................

1/ txuftrnfyga&mif;olu rdrdomw&m;0ifykdifqdkiftusdK;cHpm;cGifU&SdonfU azmfjyygajruGufESifU ,if;ajruGufyg

tusdK;cHpm;cGifUt&yf&yfukd wefbdk;aiGusyf ..............................^- (usyf............................................ )wdwdjzifU
a&mif;csvdkaMumif; tqdkjyKurf;vSrf;vm&m? txufyg0,f,loluvnf; ,if;wefbdk;jzifUyif 0,f,l&efoabmwlygonf/
2/ þokdh oabmwlnDMuonfUtavQmuf ,aehpmcsKyfcsKyfqdkonfU ( )&ufaehüyif tqdkyg
wefbdk;aiGusyf .................................^- (usyf.................................................. )wdwdukd wpfvHk;wpfcJwnf;
tajytaMu 0,f,o l rl aS y;acs&m a&mif;csou l vufc&H &Sad Mumif; 0efcyH gonf/ a&mif;olrv S nf; rdrad &mif;csonfaU jruGuf
ESifU ,if;ajruGuf\ykdifqdkifrIpmcsKyfpmwrf;? pm½Gufpmwrf;wdkhukd 0,f,lolokdh vufa&mufvTJajymif;ay;tyfonfukd 0,f,l
olrS vufcH&&SdaMumif; 0efcHygonf/
3/ azmfjyyg a&mif;csonfaU jruGuEf iS yUf wfoufí aygiEf x HS m;jcif;? vTaJ jymif;ay;tyfxm;jcif;? tarGpm;tarGct H jzpf
ay;urf;xm;jcif; tjcm;wpfenf;enf;jzifv U aJT jymif;xm;jcif;wdrhk u
S if;&Si;f ygaMumif; a&mif;csorl S wm0ef,0l efcu H wdjyKygonf/
aemufaemifwpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l wl iG w
f pfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU tuket f us
cHí vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(a&mif;csol) (0,f,lol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................
(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl...............................................ta&mif;t0,f uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
............................................. NrdKY? trSwf ( )? .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifolykdifjzpfaom ...................................................................................................................
................................................................................................................................................ukd
............................................. NrdKY? trSwf ( )? .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifxm;oltm; usyf ...............................^- (usyf........................................................ )wdwdjzihf
.................... ckESpf? .............................. v? ( )&ufaehwGif tNyD;tydkifa&mif;csvdkufygonf/
tqdkyga&mif;csvdkufaom .............................................................................................
.................................................................................................................................ukd a&mif;csol
OD;^a': ........................................u rdrdykdifqkdifNyD;? taygiftEHS? tcsKyftcs,f? vHk;0uif;&Sif;aMumif;ESifU
4if;ESifUpyfvsOf;í wpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l tl m;wpfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU
tuket f uscí H vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(a&mif;csol) (0,f,lol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)

1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] qdkif&Sif-qdkifiSm; ESpfOD;oabmwl uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
qdkif&Sif / / ............................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm ..........................................................................................................
qdkifiSm; / / ............................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm ..........................................................................................................
1/ txufwGifazmfjyygqdkif&Sifykdifqdkifaom .................................NrdKY? ....................................NrdKYe,f?
....................................aps;^&yfuGuf&Sd? ( )xyf? qdkiftrSwf( )[kac:wGifaomqdkifcef;tm; ( )v wdwd
iSm;&rf;Mu&ef oabmwlMuygonf/
2/ þokdhoabmwlnDMuonfUtavQmuf txufygqdkifcef;tm; wpfvvQif? usyf...............................jzifU
( )vtwGuf qdkifcef;c usyf....................................^- (....................................wdwd)ukdqdkifiSm;jzpf
olu tajytaMuay;acs&m? qdkif&SifjzpfolrS tjynfUt0vufcH&&SdaMumif; 0efcHuwdjyKygonf/
3/ qdkifiSm;&rf;jcif;oufwrf;onf( )rS ( )aehtxdjzpfaMumif;ESpfOD;
ESpfzufoabmwlnDMuygonf/
4/ qdkif&Sifuaomfvnf;aumif;? qdkifiSm;uaomfvnf;aumif;? riSm;vdk^raevdkMuvQif wpfOD;ukdwpfOD; pmcsKyf
ESpfrjynfUrD (1)vBudKwifí taMumif;Mum;&ygrnf/
5/ qdkifiSm;jzpfolonf qdkifcef;ESifUywfoufaom qdkifcGef? rDwmcGef? tjrwfcGefwdkhukd rdrdaiGjzifUay;aqmif
&rnfjzpfygonf/
6/ qdik if mS ;jzpfoo
l nf qdik &f iS rf odbw
J qifv U aJT jymif;jcif;? iSm;&rf;jcif;? aygiEf jHS cif;? rGr;f rHjyifqifjcif;rsm; rjyKvyk &f ef
oabmwlygonf/
txufazmfjyygtcsuftvufrsm;ukd ESpfOD;ESpfzuf zwf½I? em;vnf? oabmwlnDMuygí atmufygtod
oufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(qkdif&Sif) (qdkifiSm;)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] tdrf&Sif-tdrfiSm; ESpfOD;oabmwl uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
tdrf&Sif / / OD;^a':...................................... rSwfyHkwiftrSwf ......................................................
ukdifaqmifolykdifjzpfaom ............................................NrdKY? ...............................&yfuGuf?
.......................vrf;&Sd tdrf^wdkufcef; ................................................................... ukd
wpfvvQif...................................usyf? (usyf....................................................wdwd)
pay:aiG............................................................................................................ jzifU
tdrfiSm; / / OD;^a':. ...................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm .....................................................................................................tm;
atmufygpnf;urf;csufrsm;t&iSm;&rf;vdkufygonf/
pnf;urf;csufrsm;
1/ tdrfiSm;rStdrfvcukd vpOf vqef;( )&ufaehrS ( )&ufaehtwGif;tdrf&Sifokdhay;aqmif&rnf/
2/ tdrfiSm;jzpfolrS raevkdawmhvQifvnf;aumif;? tdrf&SifjzpfolrS rxm;vkdawmhvQifvnf;aumif;? wpfOD;ukdwpfOD;
( )v BudKwiftaMumif;Mum;&rnfjzpfygonf/
3/ tdrfiSm;&rf;jcif;oufwrf;onf( )rS ( )aehtxdjzpfaMumif; ESpfOD;ESpfzuf
oabmwlnDMuygonf/
4/ tdrfiSm;jzpfolonf tqdkygiSm;&rf;xm;onfh tdrf^wdkufcef;tm; wqifUvTJajymif;jcif;? a&mif;csjcif;? aygifESHjcif;?
vTaJ jymif;jcif;rsm; vH;k 0rjyKvyk &f yg/
5/ ............................................................................................................................................
............................................................................................................................................
txufazmfjyygtcsuftvufrsm;ukd ESpfOD;ESpfzuf zwf½I? em;vnf? oabmwlnDMuygí atmufygtod
oufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(tdrf&Sif) (tdrfiSm;)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl tdrfNcHajrta&mif;t0,f uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
a&mif;ol / / ................................................ rSwfyHkwiftrSwf ...........................................................
ae&yfvdyfpm ...............................................................................................................
0,f,lol / / ................................................ rSwfyHkwiftrSwf ............................................................
ae&yfvdyfpm ...............................................................................................................
ta&mif;t0,fjyKvkyfonfUtdrfajr
....................... wdkif;? ........................ NrdKYe,f? ........................ &yfuGuf? .......................... vrf;?
trSwf( )[kac:wGifaom tvsm;( )ay _ teH( )ay&Sd ajruGufESifU4if;ajray:wGifaqmufvkyfxm;onfU
tdrftygt0if oD;yif? pm;yif ajray: ajratmuf tusdK;cHpm;cGifUt&yf&yf -
1/ txuftrnfyga&mif;olu rdrdomw&m;0ifykdifqdkiftusdK;cHpm;cGifU&SdonfU azmfjyygajrESifUtdrf tusdK;cHpm;cGifU
t&yf&yfukd wefbdk;aiGusyf ....................................^- (usyf..................................................... )wdwdjzifU
a&mif;csvdkaMumif; tqdkjyKurf;vSrf;vm&m? txufyg0,f,loluvnf; ,if;wefbdk;jzifUyif 0,f,l&efoabmwlygonf/
2/ þokdh oabmwlnDMuonfUtavQmuf ,aehpmcsKyfcsKyfqdkonfU ( )&ufaehüyif tqdkyg
wefbdk;aiGusyf .................................^- (usyf.................................................. )wdwdukd wpfvHk;wpfcJwnf;
tajytaMu 0,f,o l rl aS y;acs&m a&mif;csou l vufc&H &Sad Mumif; 0efcyH gonf/ a&mif;olrv S nf; ,if;tdraf jrykdifqdkifrI
pmcsKyfpmwrf;? pm½Gufpmwrf;? tusKd ;cHpm;cGit Uf &yf&yfwdkhukd 0,f,lolokdh vufa&mufvTJajymif;ay;tyfonfukd 0,f,lol
rS vufcH&&SdaMumif; 0efcHygonf/
3/ azmfjyyg a&mif;csonfaU jruGuEf iS yUf wfoufí aygiEf x HS m;jcif;? vTaJ jymif;ay;tyfxm;jcif;? tarGpm;tarGct H jzpf
ay;urf;xm;jcif; tjcm;wpfenf;enf;jzifv U aJT jymif;xm;jcif;wdrhk u S if;&Si;f ygaMumif; a&mif;csorl S wm0ef,0l efcu H wdjyKygonf/
aemufaemifwpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l wl iG w
f pfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU tuket f us
cHí vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

a&mif;csol ....................................... 0,f,lol .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ 2/
.............................................................. ..............................................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl ............................................. aygifESHjcif;uwdpmcsKyf}}

aehpGJ? ckESpf? v? ( )&uf

............................................. NrdKY? trSwf ( ) .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifolykdifjzpfaom .............................................................................................................. ukd?
............................................. NrdKY? trSwf ( ) .................................................... ae?
OD;^a':.......................................trsdK;om;rSwfyHkwiftrSwf ..................................................................
ukdifaqmifxm;oltm; usyf ...............................^- (usyf........................................................ )wdwdjzihf
...............ckESpf? ................................... v? ( )&ufaehwGif aygifESHvdkufygonf/ tqdkygaygifESHvdkufonfU
................................................................................................................................................udk
aygifESHol OD;^a': ....................................... u ykdifqdkifNyD;? taygiftESH? tcsKyftcs,f? t½Iyft&Sif; vHk;0uif;&Sif;
aMumif;? 4if;ESifUpyfvsOf;í wpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygvQif rdrpd &dwjf zift U uket f uscí H vH;k 0ajyvnfonfU
wdik af tmifajz&Si;f ay;ygrnf[k aygifESHolrS0efcHuwdjyKygonf/
þpmcsKyfukd ESpfOD;ESpfzuf zwf½I? od&Sd? em;vnf? oabmwlnDMuygojzifU rdrdwdkhqE´tavsmuf atmufyg
todoufaorsm;a&SYwGif pmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

(aygifESHol) (aygifESHjcif;vufcHol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfcsKyfjzifhiSm;&rf;jcif; p&Hay; uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
ykdif&Sif / / ................................................ rSwfyHkwiftrSwf ...........................................................
ae&yfvdyfpm ...............................................................................................................
................................................................................................................................
iSm;&rf;ol / / ................................................ rSwfyHkwiftrSwf ............................................................
ae&yfvdyfpm ...............................................................................................................
................................................................................................................................
þESpfcsKyfjzifUiSm;&rf;jcif;p&Hay;uwdpmcsKyfukd ESpfOD;oabmwljyKvkyfcsKyfqkdMuonfrSm -
txuftrnfyg ydkif&SifrS 4if;ykdifqkdifaom ..................................................................................
.......................................................................................................................................................
...................................................................................................................................................
ukd
iSm;&rf;oltm; ESpfcsKyfp&Hay;pepfjzifU wpfvvQif ............................. usyfEIef;jzifU iSm;&rf;rnfjzpfNyD; ( v^ESpf)
twGuf p&HaiGusyf ............................... (usyf .................................................................... wdwd)ukd
,aeh ( )aehwGif iSm;&rf;olrS ykid &f iS jf zpfot
l m;ay;acsí ykid &f iS rf v S nf;vufc&H &Sad Mumif;0efcu
H wdjyKyg
onf/ usefaiGusyf ........................... ^- (usyf...............................................wdwd)ukd ( )&uf
aehwGif ay;acsrnfjzpfaMumif; ESpfOD;oabmwlnDMuygonf/
tu,fí ykdif&SifbufrS iSm;&rf;&efysufuGufcJhaomf &,lxm;NyD;aomp&HaiGtjyif ,if;p&HaiG\ (2)qukd
jyefvnfay;avQmf&rnf/ iSm;&rf;olbufrSysufuGufcJhaomfp&HaiGukdtqHk;cH&rnfjzpfaMumif;0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

ykdif&Sif ....................................... iSm;&rf;ol .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ 2/
.............................................................. ..............................................................

.............................................................. ..............................................................
 xdrf;jrm;r*Fvm uwdopömjyKvTm
trnf ....................................... trnf .......................................

touf ...................................... touf ......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

vlrsdK;^bmom ...................................... vlrsdK;^bmom ......................................
tvkyftukdif ...................................... tvkyftukdif ......................................
tbrnf ...................................... tbrnf ......................................

trdtrnf ...................................... trdtrnf ......................................

ae&yfvdyfpm ...................................... ae&yfvdyfpm ......................................

...................................... ......................................

uRefawmf^uRefrwdkYu þxdrf;jrm;r*Fvm uwdopömjyKvTmukd jyKvkyftyfygonf/ rdrdwdkYonf t½G,fa&muf

&Sdolrsm;jzpfMuNyD; vGwfvyfolrsm;jzpfí wpfOD;ESifUwpfOD; arwÅmouf0if cspfcifpHkruf ESpfoufjrwfEdk;MuygojzifU? tMuif
vifr,m;tjzpf ½dk;ajrus &moufyef aygif;oif;aexdkifMu&ef &nfpl;vsuf þvufxyfr*Fvm uwdopömjyKvTmukd
jyKvkyfMuygonf/
uRefawmf^uRefrwdkhu ,ckcsdefrSpNyD; w&m;0if tMuifvifr,m;jzpfí wpfOD;ukdwpfOD; vif0wÅ&m;ig;yg;?
r,m;0wÅ&m;ig;yg;ESifUtnD toufxufqHk; cspfcifMuifempGmjzifU aygif;oif;aexdkifoGm;Muygrnf[k toD;oD;0efcH uwd
jyKygonf/
uRefawmf^uRefrwdkhonf rnfolwpfOD;wpfa,mufrQ wdkufwGef;jcif;? tEdkiftxufjyKusifUapcdkif;jcif;? Ncdrf;
ajcmufjcif;? zsm;a,mif;aoG;aqmifjcif; tvsOf;r&SdyJ rdrdwdkh\ vGwfvyfaomoabmqE´t& þxdrf;jrm;r*Fvm uwd
opömjyKvTmukd jyKvkyfMuygonf/
(todoufaorsm;) owdkhom;vufrSwf ......................................

owdkhorD;vufrSwf ......................................
1/ - ckESpf? v? ( )&ufaehü uREfkyf\a&SYarSmufwGif
..........................................

.......................................... uwdopömjyKí vufrSwfa&;xdk; w&m;0ifvufxyfMuonf/

2/
..........................................

..........................................
 ]] ESpfOD;oabmwl tdrfNcHajrta&mif;t0,f p&Hay;uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
a&mif;ol / / ................................................ rSwfyHkwiftrSwf ...........................................................
ae&yfvdyfpm ...............................................................................................................
0,f,lol / / ................................................ rSwfyHkwiftrSwf ............................................................
ae&yfvdyfpm ...............................................................................................................
ta&mif;t0,fp&Hay;jcif;jyKvkyfonfUtdrfajr
....................... wdkif;? ........................ NrdKYe,f? ........................ &yfuGuf? .......................... vrf;?
trSwf( )[kac:wGifaom tvsm;( )ay _ teH( )ay&Sd ajruGufESifU4if;ajray:wGifaqmufvkyfxm;onfU
tdrftygt0if oD;yif? pm;yif ajray: ajratmuf tusdK;cHpm;cGifUt&yf&yf -
1/ txuftrnfyga&mif;olu rdrdomw&m;0ifykdifqdkiftusdK;cHpm;cGifU&SdonfU azmfjyygajrESifUtdrf tusdK;cHpm;cGifU
t&yf&yfukd wefbdk;aiGusyf ....................................^- (usyf..................................................... )wdwdjzifU
a&mif;csvdkaMumif; tqdkjyKurf;vSrf;vm&m? txufyg0,f,loluvnf; ,if;wefbdk;jzifUyif 0,f,l&efoabmwlygonf/
2/ ,aehpmcsKyfcsKyfonfUaehwGif 0,f,lolu a&mif;csoltm;p&HaiG usyf ...........................................^-
(usyf........................................................ )wdwdukd ay;xm;NyD;? usefaiG usyf ...............................^-
(usyf......................................................... )wdwdukd ( )aehwGif tajytaMuay;acsrnfjzpf
aMumif;? 0,f,o l u l 0efcNH y;D tu,fí ay;acs&efysuu f u
G cf v
hJ Qif ay;xm;onfpU &HaiG tqH;k ½I;H cHrnfjzpfaMumif; 0efcH
ygonf/ a&mif;csou l vnf; 0,f,o l u l aiGtajytaMuay;aqmifEikd yf gvQuf rdrrd aS &mif;cs&efysuu f u
G cf yUJ gvQif &,l
xm;Ny;D aomp&HaiGtjyif ,if;p&HaiG\ (2)qukd jyefvnfay;avQmrf nfjzpfaMumif; 0efcu H wdjyKygonf/
3/ azmfjyyg a&mif;csonft U rd Nf caH jrESiyUf wfoufí aygiEf x HS m;jcif;? vTaJ jymif;ay;tyfxm;jcif;? tarGpm;tarGct H jzpf
ay;urf;xm;jcif; tjcm;wpfenf;enf;jzifv U aJT jymif;xm;jcif;wdrhk S uif;&Si;f ygaMumif; a&mif;csorl S wm0ef,0l efcu H wdjyKygonf/
aemufaemifwpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l wl iG wf pfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU tuket f us
cHí vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k a&mif;csorl S 0efcu H wdjyKygonf/
txufazmfjyygtcsut f vufrsm;udk ESpOf ;D oabmwl zwf½?I od&?dS em;vnfoabmayguMf uí atmufyg
todoufaorsm;a&Sw Y iG pf mcsKyf csKyq f kd vufrw S af &;xd;k Muygonf/

a&mif;csol ....................................... 0,f,lol .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ 2/
.............................................................. ..............................................................

.............................................................. ..............................................................
 ]] tdrf&Sif-tdrfiSm; ( ) csKyfjzifh iSm;&rf;jcif;uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
tdrf&Sif / / OD;^a':...................................... rSwfyHkwiftrSwf ......................................................
vdyfpm .................................................................................................................
tdrfiSm; / / OD;^a':. ...................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm ...........................................................................................................
1/ txufazmfjyygtdrf&Sifykdifqdkifaom ................................................NrdKY? ................................&yfuGuf?
...................................vrf;? tdrftrSwf( )[kac:wGifaom tdrf^wdkufcef;tm; wpfvvQifaiGusyf
....................................^(usyf...................................................... wdwd)EIef;jzifU ( )twGuf
...................................^(usyf.......................................................wdwd)tm; tdrfiSm;jzpfolrSay;acs
&m tdrf&SifrSaumif;pGmvufcH&&SdygaMumif; 0efcHygonf/
2/ tdrfiSm;&rf;jcif;oufwrf;onf( )rS ( )aehtxdjzpfaMumif; ESpfOD;ESpfzuf
oabmwlnDMuygonf/
3/ iSm;&rf;pOftcsdefumvtwGif; usoifUaomrDwmcukd iSm;&rf;oluomay;aqmif&ef oabmwlnDMuygonf/
4/ tdrfiSm;jzpfolrS raevkdawmhvQifvnf;aumif;? tdrf&SifjzpfolrS rxm;vkdawmhvQifvnf;aumif;? wpfOD;ukdwpfOD;
( )v BudKwiftaMumif;Mum;&rnfjzpfygonf/
5/ pmcsKyfoufwrf;jynfhaom ( )aehwGif tdrfiSm;onf tdrfcef;tm;rlviSm;&rf;pOfutajctae
twdkif; tdrf&Sifokdhjyefvnfay;tyf&ygrnf/
6/ tdrfiSm;jzpfolonf tqdkygiSm;&rf;xm;onfh tdrf^wdkufcef;tm; wqifUvTJajymif;jcif;? a&mif;csjcif;? aygifESHjcif;?
vTaJ jymif;jcif;rsm; vH;k 0rjyKvyk &f yg/
7/ tdrif mS ;rS Oya'ESirfU vGwu f if;aom vkyif ef;rsm;rvkyu f idk &f efoabmwlygonf/ tu,fívkyu f idk cf aUJ omfjzpfay:
vmaomudpt ö 00onf tdr&f iS Ef iS v Uf ;kH 0ywfoufjcif;r&Sb d J tdrif mS ;jzpfo\ l wm0efomjzpfaMumif;oabmwlygonf/
txufazmfjyygtcsuftvufrsm;ukd ESpfOD;ESpfzuf zwf½Iem;vnf? oabmwlnDMuygí atmufygtodoufao
rsm;a&SYwGif rdrdwdkh\vGwfvyfaomoabmqE´t& pmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

(tdrf&Sif) (tdrfiSm;)

.............................................................. ..............................................................

(todoufaorsm;)
1/ .............................................................. 2/ ..............................................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwlarmfawmfum;iSm;&rf;jcif;uwdpmcsKyf}}
aehpGJ?................................................
um;ykdif&Sif / / rSwfyHkwiftrSwf ......................................................
................................................

ae&yfvdyfpm ........................................................................................................
um;iSm;&rf;ol / / ................................................rSwfyHkwiftrSwf ......................................................
ae&yfvdyfpm ........................................................................................................
þarmfawmfum;iSm;&rf;jcif;uwdpmcsKyfukd atmufygtwdkif; ESpfOD;oabmwlcsKyfqdkMuonfrSm -
um;ykdif&Sifjzpfol OD;^a': ........................................rSwfyHkwiftrSwf ............................................ u
ykdifqdkifNyD;? tusdK;cHpm;vQuf&Sdaom ,mOftrSwf ...............................................................................................
.......................................................................................................................................................... tm;

wpfvvQif ...........................^- (usyf .............................................. wdwd)? pay:aiG ...............................^-

(usyf ......................................... wdwd)jzifUiSm;&rf;&ef oabmwlpmcsKyfcsKyfqdkMujcif;jzpfygonf/
(1) armfawmfum;iSm;&rf;jcif;umvonf ( . . )&ufaehrS ( . . )xd ( )vwdwdjzpfygonf/
(2) iSm;&rf;onfUarmfawmfum; ......................................... twGuf ............................................................. rS
tcGeftcrsm;ay;aqmifoGm;&efuwdjyKygonf/
(3) um;iSm;&rf;olrS um;iSm;&rf;cukd vpOfvwdkif; ( )&ufaehwGifaemufqHk;xm;ay;aqmif&ef uwdjyKygonf/
(4) um;iSm;&rf;jcif;oufwrf;jynfUíum;iSm;&rf;olrSvnf;aumif;? um;ykdif&SifrSaomfvnf;aumif;? qufvufriSm;vkdygu
( )v BudKwiftaMumif;Mum;&ef ESpfOD;ESpfzuf em;vnfMuygonf/
(5) um;iSm;&rf;olonf rdrdiSm;&rf;xm;onfUum; ................................................. tm; jyefvnfay;tyfonfUtcg
&,lpOfutajctaetwdkif; jyefvnfay;tyf&ef 0efcHuwdjyKygonf/
(6) um;ykdif&Sifuvnf; um;iSm;&rf;olrS um;jyefvnfay;tyfonfUtcg wifxm;onfUpay:aiG ...............................^-
(usyf ......................................... wdwd)ukd wpfvHk;wpfcJwnf; jyefvnfay;tyf&ef uwdjyKygonf/
(7) um;ykdif&Sif\tarGpm;tarGcHrsm;rS aESmuf,Sufjcif;&SdcJUygu um;ykdif&SifrSwm0ef,lajz&Sif;ay;&rnfjzpfygonf/
(8) um;iSm;&rf;olonf tqdkyg iSm;&rf;xm;onfUum;tm; xyfqifUiSm;&rf;jcif;? a&mif;csjcif;rjyK&yg/ um;iSm;&rf;olonf
&mZ0wfrIESifUruif;aomudpörsm;jyKvkyfcJUygu rdrd\wm0efomjzpfapNyD;vQif um;ykdif&SifESifUoufqdkifjcif;r&Sdap&yg/
txufazmfjyygtcsuftvufrsm;ukd ykdif&SifjzpfolESifUiSm;&rf;olwdkh ESpfOD;oabmwlnDMuygí atmufygtodoufao
rsm;a&SYwGif pmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(armfawmfum;ykdif&Sif) (armfawmfum;iSm;&rf;ol)

.............................................................. ..............................................................

(todoufaorsm;)
1/ ..............................................................
2/ ..............................................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl( )csKyfjzifh armfawmfum;iSm;&rf;jcif;uwdpmcsKyf}}
aehpGJ?................................................
um;ykdif&Sif / / rSwfyHkwiftrSwf ......................................................
................................................

ae&yfvdyfpm ........................................................................................................
um;iSm;&rf;ol / / ................................................rSwfyHkwiftrSwf ......................................................
ae&yfvdyfpm ........................................................................................................
þarmfawmfum;iSm;&rf;jcif;uwdpmcsKyfukd atmufygtwdkif; ESpfOD;oabmwlcsKyfqdkMuonfrSm -
um;ykdif&Sifjzpfol OD;^a': ........................................rSwfyHkwiftrSwf ............................................ u
ykdifqdkifNyD;? tusdK;cHpm;vQuf&Sdaom ,mOftrSwf ...............................................................................................
.......................................................................................................................................................... tm;

iSm;&rf;&ef wpfvvQif ...........................^- (usyf ................................................... wdwd)jzifU ( )twGuf

...........................^- (usyf ............................................. wdwd)ukd um;iSm;&rf;olrSay;acs&m um;ydkif&SifjzpfolrS

aumif;pGmvufcH&&SdygaMumif; 0efcHygonf/
(1) armfawmfum;iSm;&rf;jcif;umvonf ( . . )&ufaehrS ( . . )xd( )wdwdjzpfygonf/
(2) iSm;&rf;onfUarmfawmfum; ......................................... twGuf ............................................................. rS
tcGeftcrsm;ay;aqmifoGm;&efuwdjyKygonf/
(3) um;iSm;&rf;jcif;oufwrf;jynfUíum;iSm;&rf;olrSvnf;aumif;? um;ykdif&SifrSaomfvnf;aumif;? qufvufriSm;vkdygu
( )v BudKwiftaMumif;Mum;&ef ESpfOD;ESpfzuf em;vnfMuygonf/
(4) um;iSm;&rf;olonf rdrdiSm;&rf;xm;onfUum; ................................................. tm; jyefvnfay;tyfonfUtcg
&,lpOfutajctaetwdkif; jyefvnfay;tyf&ef 0efcHuwdjyKygonf/
(5) um;ykdif&Sif\tarGpm;tarGcHrsm;rS aESmuf,Sufjcif;&SdcJUygu um;ykdif&SifrSwm0ef,lajz&Sif;ay;&rnfjzpfygonf/
(6) tqdkygum;ukd iSm;&rf;olrS wqifUvTJajymif;iSm;&rf;jcif;? a&mif;csjcif;wdkhrjyKvkyf&yg/ um;iSm;&rf;olonf&mZ0wfrIESifU
ruif;aomudpörsm;jyKvkyfcJUygu rdrd\wm0efomjzpfapNyD;vQif um;ykdif&SifESifUoufqdkifjcif;r&Sdap&yg/
txufazmfjyygtcsuftvufrsm;ukd ykdif&SifjzpfolESifUiSm;&rf;olwdkh ESpfOD;oabmwlnDMuygí atmufygtodoufao
rsm;a&SYwGif pmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

(armfawmfum;ykdif&Sif) (armfawmfum;iSm;&rf;ol)

.............................................................. ..............................................................

(todoufaorsm;)
1/ ..............................................................
2/ ..............................................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwlarmfawmfum;ta&mif;t0,fuwdpmcsKyf}}
aehpGJ?................................................
um;ykdif&Sif / / rSwfyHkwiftrSwf ......................................................
................................................

ae&yfvdyfpm ........................................................................................................
um;0,f,lol / / ................................................rSwfyHkwiftrSwf ......................................................
ae&yfvdyfpm ........................................................................................................
ta&mif;t0,f/ / .............................................................................................................................
jyKvkyfonfhum; .........................................................................................................................
þarmfawmfum;ta&mif;t0,fuwdpmcsKyfukd atmufygtwdkif; ESpfOD;oabmwlcsKyfqdkMuonfrSm -
1/ txuftrnfygum;ydkif&Sifonf rdrdykdifqdkifaom azmfjyygum;tm; wefbdk;aiGusyf ................................^-
(usyf................................................ )wdwdjzifU a&mif;csvdkaMumif; tqdkjyKurf;vSrf;vm&m? txufyg0,f,lolu
vnf; ,if;wefbdk;jzifUyif 0,f,l&efoabmwlygonf/
2/ þokdh oabmwlnDMuonfUtavQmuf ,aehpmcsKyfcsKyfqdkonfU ( )&ufaehüyif tqdkyg
wefbdk;aiGusyf .................................^- (usyf.................................................. )wdwdukd wpfvHk;wpfcJwnf;
tajytaMu 0,f,lolrSay;acs&m a&mif;csoluvufcH&&SdaMumif; 0efcHygonf/ a&mif;olrSvnf; rdrda&mif;csonfU
armfawmfum;ESifU ,if;armfawmfum;\ykdifqdkifrIpmcsKyfpmwrf;? pm½Gufpmwrf;wdkhukd 0,f,lolokdh vufa&mufvTJajymif;
ay;tyfonfukd 0,f,lolrS vufcH&&SdaMumif; 0efcHygonf/
3/ azmfjyyg a&mif;csonfaU rmfawmfum;ESiyUf wfoufí oufqikd &f m,mOfrpI pf½;kH wGiaf y;aqmif&ef 'gPaf Mu;rsm;&Scd yUJ g
u a&mif;csonfaU ehrwkid rf t D xd 'gPaf Mu;rsm;tm;vH;k ukd a&mif;csorl S tajytaMuay;oGi;f &ygrnf/ xdjhk yifaygiEf x HS m;jcif;?
vTaJ jymif;ay;tyfxm;jcif;? tarGpm;tarGct H jzpf ay;urf;xm;jcif; tjcm;wpfenf;enf;jzifv U aJT jymif;xm;jcif;wdrhk S uif;&Si;f
ygaMumif;ukv d nf; a&mif;csorl S wm0ef,0l efcH uwdjyKygonf/ aemufaemifwpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu
0,f,o l wl iG w
f pfpw
kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU tuket f uscí H vH;k 0ajyvnfonfw U ikd af tmifajz&Si;f ay;ygrnf[k
a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

(armfawmfum;ykdif&Sif) (armfawmfum;0,f,lol)

.............................................................. ..............................................................

(todoufaorsm;)
1/ ..............................................................
2/ ..............................................................

.............................................................. ..............................................................
 ]] qdkif&Sif-qdkifiSm; ( ) csKyfjzifh iSm;&rf;jcif;uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
qdkif&Sif / / ............................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm ..........................................................................................................
qdkifiSm; / / ............................................... rSwfyHkwiftrSwf .......................................................
ae&yfvdyfpm ..........................................................................................................
1/ txufwGifazmfjyygqdkif&Sifykdifqdkifaom .................................NrdKY? ....................................NrdKYe,f?
....................................aps;^&yfuGuf&Sd? ( )xyf? qdkiftrSwf( )[kac:wGifaomqdkifcef;tm; ( )v wdwd
iSm;&rf;Mu&ef oabmwlMuygonf/
2/ þokdhoabmwlnDMuonfUtavQmuf txufygqdkifcef;tm; wpfvvQif? usyf...............................jzifU
( )vtwGuf qdkifcef;c usyf....................................^- (....................................wdwd)ukdqdkifiSm;jzpf
olu tajytaMuay;acs&m? qdkif&SifjzpfolrS tjynfUt0vufcH&&SdaMumif; 0efcHuwdjyKygonf/
3/ qdkifiSm;&rf;jcif;oufwrf;onf( )rS ( )aehtxdjzpfaMumif;ESpfOD;
ESpfzufoabmwlnDMuygonf/
4/ qdkif&Sifuaomfvnf;aumif;? qdkifiSm;uaomfvnf;aumif;? riSm;vdk^raevdkMuvQif wpfOD;ukdwpfOD; pmcsKyf
ESpfrjynfUrD (1)vBudKwifí taMumif;Mum;&ygrnf/
5/ qdkifiSm;jzpfolonf qdkifcef;ESifUywfoufaom qdkifcGef? rDwmcGef? tjrwfcGefwdkhukd rdrdaiGjzifUay;aqmif
&rnfjzpfygonf/
6/ qdik if mS ;jzpfoo
l nf qdik &f iS rf odbw
J qifv U aJT jymif;jcif;? iSm;&rf;jcif;? aygiEf jHS cif;? rGr;f rHjyifqifjcif;rsm; rjyKvyk &f ef
oabmwlygonf/
txufazmfjyygtcsuftvufrsm;ukd ESpfOD;ESpfzuf zwf½I? em;vnf? oabmwlnDMuygí atmufygtod
oufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(qkdif&Sif) (qdkifiSm;)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl ............................................. iSm;&rf;jcif;uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
ykdif&Sif / / ................................................................................................................................

iSm;&rf;ol / / ................................................................................................................................

iSm;&rf;onfht&m / ................................................................................................................................

................................................................................................................................

þiSm;&rf;jcif;uwdpmcsKyfukd ESpfOD;oabmwlcsKyfqdkMuonfrSm -
ykdif&Sifjzpfol OD;^a': ........................................rSwfyHkwiftrSwf ............................................ u
ykdifqdkifNyD;? tusdK;cHpm;vQuf&Sdaom .................................................tm; ..........................................NrdKY?
trSwf( )? ........................vrf;? .............................&yfuGuf? rSwfyHkwiftrSwf ......................................
ukdifaqmifol? OD;^a': .........................rS wpfvvQif ....................... ^- (usyf.....................................wdwd)
jzifUiSm;&rf;&ef atmufygpnf;urf;csufrsm;twdkif; ESpfOD;oabmwliSm;&rf;jcif;uwdpmcsKyf csKyfqkdMuygonf/
1/ txufazmfjyyg .................................................ukd ( )aehrS ( )aeYtxd
( )v^ESpf wdwd iSm;&rf;&ef oabmwlnDMuygonf/
2/ iSm;&rf;olrS iSm;&rf;cukd vpOft*Fvdyfvqef;( )aehrwdkifrD rSefrSefay;aqmifoGm;&ef oabmwluwdjyKygonf/
3/ iSm;&rf;olonf ykdif&Sif\cGifUjyKcsuf wpfpHkwpf&mr&SdyJ wqifUiSm;&rf;jcif;? aygifESHjcif;? a&mif;csjcif;? vTJajymif;jcif;
rjyKvkyf&yg/
4/ ykdif&SifrSaomfvnf;aumif; iSm;&rf;olrSvnf;aumif; riSm;vdkawmhvQif wpfOD;ESifUwpfOD; ( )v BudKwiftaMumif;
Mum;&ef oabmwlMuygonf/
txufazmfjyygtcsuftvufrsm;ukd ykdif&SifjzpfolESifUiSm;&rf;olwdkh ESpfOD;oabmwlnDMuygí atmufyg
todoufaorsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/
(ykdif&Sif) (iSm;&rf;ol)

trnf ....................................... trnf .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ trnf ....................................... 2/ trnf .......................................

rSwfyHkwiftrSwf ....................................... rSwfyHkwiftrSwf .......................................

ae&yf ....................................... ae&yf .......................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl aiG,HkMunftyfESHjcif; uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf

aiG,HkMunftyfESHol / / ................................................ rSwfyHkwiftrSwf .................................................

ae&yfvdyfpm ....................................................................................................
aiGvufcHol / / ................................................ rSwfyHkwiftrSwf .................................................
ae&yfvdyfpm ....................................................................................................

OD;^a':.................................. u ...............................................................................
........................................................................... oHk;pGJ&eftwGuf aiGvdktyfygojzifU tultnDawmif;cHvm&m
OD;^a': ...................................... uvnf; rdrdykdifaiG ...........................................................................^-
(usyf............................................................................................. wdwd)ukd ,HkMunfpGm arwÅmapwemjzifU
tultnDay;urf; tyfEx HS m;jcif;jzpfygonf/ 4if;aiGEiS yUf wfoufí twd;k EIe;f uif;pGmjzifU tusKd ;tjrwfwpfpw kH pf&m&,ljcif;
r&SdyJ apwemoufoufjzifU ulnDxm;jcif;jzpfygonf/
4if;ulnDaiGukd (......................................)aehwGif ay;tyfNyD; aiGvufcHol (aiGvufcHol[kqdk&m
wGif tqdkygulnDaiGudkvufcH&,loltjyif 4if;ESihfywfoufaom tarGpm;tarGcHrsm; yg0ifonf[krSwf,l&rnf/)uvnf;
(......................................)aehwGif aemufqHk;xm;í ,HkMunfulnDoltm; taMutvnfjyefvnfí ay;qyfygrnf/
tu,fí 4if;aiGjyefay;qyf&rnfUaehwGif ay;qyf&efuwdysufuGufcJUNyD; ,HkMunfrIukdtvGJoHk;pm;jyK
vkyfrdygu aiG,HkMunftyfESHcH&olonf aiG,HkMunftyfESHulnDcJUol OD;^a': ...................................\ tpDtrHtwdkif;
auseyfonftxd vdkufvHaqmif½Gufygrnf[k rdrdukd,fykdifqE´t& atmufygtodoufaorsm;a&SYwGif uwdjyK vufrSwf
a&;xdk;ygonf/

aiGay;ulnDol ....................................... aiGvufcHol .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ 2/
.............................................................. ..............................................................

.............................................................. ..............................................................
 ]] ESpfOD;oabmwl tdrfNcHajrta&mif;t0,f uwdpmcsKyf}}
aehpGJ? ckESpf? v? ( )&uf
a&mif;ol / / ................................................ rSwfyHkwiftrSwf ...........................................................
ae&yfvdyfpm ...............................................................................................................
0,f,lol / / ................................................ rSwfyHkwiftrSwf ............................................................
ae&yfvdyfpm ...............................................................................................................
ta&mif;t0,fjyKvkyfonfUtdrfajr
....................... wdkif;? ..................... NrdKYe,f? ..................... &yfuGuf? ....................... vrf;? trSwf( )[k
ac:wGifaom tvsm;( )ay _ teH( )ay&Sd ajruGufESifU 4if;ajray:wGifaqmufvkyfxm;onfUtdrf tygt0if oD;yif? pm;yif
ajray: ajratmuf tusdK;cHpm;cGifUt&yf&yf -
1/ txuftrnfyga&mif;olu rdrdomw&m;0ifykdifqdkiftusdK;cHpm;cGifU&SdonfU azmfjyygajrESifUtdrftusdK;cHpm;cGifUt&yf&yf ukd
wefbdk;aiGusyf ....................................^- (usyf..................................................... )wdwdjzifU a&mif;csvdkaMumif;
tqdkjyKurf;vSrf;vm&m? txufyg0,f,loluvnf; ,if;wefbdk;jzifUyif 0,f,l&efoabmwlygonf/
2/ þokdh oabmwlnDMuonfUtavQmuf ,aehpmcsKyfcsKyfqdkonfU ( )&ufaehüyif tqdkyg wefbdk;aiG
usyf ..............................^- (usyf.............................................. )wdwdukd wpfvHk;wpfcJwnf; tajytaMu 0,f,o l rl S
ay;acs&m a&mif;csou l vufc&H &Sad Mumif; 0efcyH gonf/ a&mif;olrv S nf; ,if;tdraf jrykdifqdkifrI pmcsKyfpmwrf;? pm½Gufpmwrf;?
tusKd ;cHpm;cGit Uf &yf&yfwdkhukd 0,f,lolokdh vufa&mufvTJajymif;ay;tyfonfukd 0,f,lol rS vufcH&&SdaMumif; 0efcHygonf/
3/ azmfjyyg a&mif;csonfaU jruGuEf iS yUf wfoufí aygiEf x HS m;jcif;? vTaJ jymif;ay;tyfxm;jcif;? tarGpm;tarGct H jzpf ay;urf;
xm;jcif; tjcm;wpfenf;enf;jzifU vTaJ jymif;xm;jcif;wdrhk S uif;&Si;f ygaMumif; a&mif;csorl S wm0ef,0l efcu H wdjyKygonf/ aemufaemif
wpfpw kH pf&mt½Iyt f &Si;f ay:ayguv f mygu 0,f,o l wl iG w
f pfpw kH pf&mepfemrIr&Sad p&bJ? rdrpd &dwjf zifU tuket f uscí H vH;k 0ajyvnfonfU
wdik af tmif ajz&Si;f ay;ygrnf[k a&mif;csolrS 0efcHuwdjyKygonf/
txufazmfjyygtcsuftvufrsm;udk ESpfOD;oabmwl zwf½I? od&Sd? em;vnfoabmaygufMuí atmufygtodoufao
rsm;a&SYwGifpmcsKyf csKyfqdk vufrSwfa&;xdk;Muygonf/

a&mif;csol ....................................... 0,f,lol .......................................

rSwfyHkwiftrSwf ...................................... rSwfyHkwiftrSwf ......................................

(todoufaorsm;)
1/ 2/
.............................................................. ..............................................................

.............................................................. ..............................................................