gr So - ary HDarvchain YSR Vahana Mitra 2023-2024 FIELD VERIFICATION FORM Secretariat Details Secretariat Name PALLECHERUVU Volunteer Name JALATAK Secretariat Code 11090590 Cluster ID. 11090590002 ‘Application Basic Details Application ID '$152308011846383584 Application Date (O1-AUG-2023 Name TRAMESH(3564) ‘Aadhaar No. XOXO SSES Date of Birth 10-May-1978 Gender MALE Father Name/ Husband Income Certificate No.__|_1C280717462239 Name Caste Certificate No. (CGC230717465897 Caste SC ‘Sub Caste, ‘Adi Dravida Eligibility Criterion Category ‘As per System Validation ‘As per Field Verification Monthly Family Income Rs Rs Dry land holding of family 0 Acres ‘Acres Wet Land holding of Family. 0 Acres ‘Acres Four-Wheeler in Family NO. Yes/No ‘Any person in the Family a Yes/No working in Central/State Govt/PSU/Private etc. with Fee income more than 12000/- fate o Electricity consumption 783 _Units Units Urban property 0 insaft Insaft Income tax payee in family NO) Yes No Field Verifier Details WEA/WWDS Name _[_Aswinikumar M Employee ID. 74882817 Time and Date Recommendation Remarks | solemnly swear that the above-mentioned particulars are true to the best of my knowledge and belief, and it conceals nothing and that no part of it is false. In case if found in future that the declaration given above is false, | am liable for prosecution. Signature of the Applicant Signature of the WEA/WWDS 7/8/2023 @ 14:25:21