[Form ‘A’ appendix]

GOVERNMENT OF PAKISTAN
MINISTRY OF RELIGIOUS AFFAIRS & INTERFAITH HARMONY
*******

APPLICATION FORM FOR GRANT OF FINANCIAL ASSISTANCE

1. Name: ---------------------------------------------------------------------------------------------------
2. Father’s/Husband’s Name: ---------------------------------------------------------------------------
3. National Identity Card No: ---------------------------------------------------------------------------
(attach attested copy of CNIC with valid date)
4. Complete Postal Address: ----------------------------------------------------------------------------
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5. DOB / Age: ---------------------------------- 6. Community: ---------------------------------------
7. Profession: ---------------------------------------------------------------------------------------------
8. Purpose for which financial help is required: -----------------------------------------------------
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9. Signature of the applicant: ---------------------------------------------------------------------------

Verified/recommended for grant of Amount of Rs.-------------------

Financial assistance by a Parliamentarian approved for payment to the
or DCO or Members, National Commission applicant.
for Minorities, or Member of District
Minority Committee Member/Local
Officer of ETPB or Member of Church Signature----------------------
Committee/ Hindu Panchayat or other (Minority MNA)
Religious committees/organizations
(by any one of the above).

Date

Stamp.