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    Jakaria Hussain applies for the Distribution of E-Rickshaw course. He provides personal details including his name, father's name and address, age, education level achieved, religion, community, family income, and that no family member has received prior training. He confirms the uploaded details are true and signs the application.

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    Jakaria Hussain applies for the Distribution of E-Rickshaw course. He provides personal details including his name, father's name and address, age, education level achieved, religion, community, family income, and that no family member has received prior training. He confirms the uploaded details are true and signs the application.

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    © All Rights Reserved
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    6 views1 page

    Form PHP

    Uploaded by

    romeoahmed687
    Jakaria Hussain applies for the Distribution of E-Rickshaw course. He provides personal details including his name, father's name and address, age, education level achieved, religion, community, family income, and that no family member has received prior training. He confirms the uploaded details are true and signs the application.

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    of 1

    Firefox https://assamminority.com/form.php?c=vR4Wcja9OXMNFAq2ZxvP...

    To,
    The Director,
    Assam Minori�es Development Board,
    R.G.B. Road, Ganeshguri, Near Sinha Lodge,
    Guwaha�, 781006
    Applica�on No: 2024/DER/10072018

    Applica�on for the DISTRIBUTION OF E-RICKSHAW course


    1. Name in Full (Block Le�er) : JAKARIA HUSSAIN
    2. Sex : Male
    3. Father´s / Guardian Name and : SAHID ALI
    Address
    Vill/ Town : OZAGAON
    P.O.: NIZ KHARUPETA
    P.S.: DHULA
    Block: PUB-MANGALDAI
    Dist.: DARRANG
    State: ASSAM
    PIN: 784115
    Mobile No.: 6001244855
    AADHAAR No.: 819192713193
    4. Educa�onal Qualifica�on : HSLC (12)
    (i) HS Gradua�on Percentage :
    5. Other Qualifica�on :
    6. Caste : GENERAL (UR)
    6. Community : MUSLIM
    6. Religion : ISLAM
    7. Age on 1st January, 2024 : 24 years
    8. Family Annual Income : 95,000.00
    9. Whether any training received : NA
    for this office by your family
    member
    Descrip�on :
    10. MCB : YES

    The details uploaded above are true and no false informa�on here has been submi�ed.
    Date : 20/01/2024
    Place : PUB-MANGALDAI

    Signature of applicant

    1 of 1 20-Jan-24, 12:25 PM

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