Applicant's Basic Information

Salutation First Name Middle Name Last Name

Mr. AMARNATH NA MAJI
Date of Birth Age Gender Date of Application
30-APRIL-2000 23 Male 21-DECEMBER-2023
Mobile No E-mail Aadhaar Card No
8617099700 amarnathmaji56@gmail.com 216970546459

Permanent Address of Applicant

Country State District Sub-division

India West Bengal Paschim Bardhaman Asansol
Block/Municipality/Municipal Block/Municipality/Municipal
Rural or Urban Village or Ward
Corporation Corporation Name
U 13
MC Asansol (Municipal Corp)
Police Station Post Office Address Line 1 Address Line 2

.0
Asansol North Nischinta BO t2Nischinta ,Pal para NA
Pin Code
713373
ic
Present Address of Applicant

Same Address As Country State District

tr

permanentAddrApplicant India West Bengal Paschim Bardhaman

is

Block or Municipality or Block or Municipality or

Sub Division Rural or Urban
Corporation Corporation Name
Asansol U
D

MC Asansol (Municipal Corp)

Village or Ward Name Police station Post Office Address Line 1
e-

13 Asansol North Nischinta BO Nischinta ,Pal para

Address Line 2 PIN Code
NA 713373

Parent or Husband details

Parent or Husband Salutation First Name Middle Name

Mother Mrs. LAXMI NA
Details of Parents Business or
Last Name Occupation
Service
MAJI HOUSEWIFE
A tea shop

Applicant Place of Birth

Same Address As Country State District

permanentAddrApplicant India West Bengal Paschim Bardhaman
Block or Municipality or Block or Municipality or
Sub Division Rural or Urban
Corporation Corporation Name
Asansol U
MC Asansol (Municipal Corp)

Generated on : 2023-12-26T11:33:19.795

P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen
 Village or Ward Name Police station Post Office Address Line 1
13 Asansol North Nischinta BO Nischinta ,Pal para
Address Line 2 PIN Code
NA 713373

Education Detail of Applicant

Name of Institution Class From Class To From Year To Year

SRIPUR HIGH V XII 2009 2017

SCHOOL

Particulars of stay of last 15 years

Block
Block or
or Muni

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Muni cipali Villag
Rural cipali ty or Polic Addr
Sub e or Post Addr Hous
Coun Distri or ty or Muni e ess PIN From To
try State ct Divisi
on Urba Muni cipal Ward
Nam
t2 Stati Offic
e
ess
Line Line Code Date Date e
Type
n cipal Corp on 2
e 1
Corp orati
orati on
on Nam
ic
e
tr

Asan
Pasc sol Nisc
West him Asan Nisc 2000 2023
Asan (Mun hinta 7133
India Beng Bard U MC 13 sol hinta -04-3 -12-2 Own
is

sol icipal ,Pal 73

al ham North BO 0 0
Corp para
an )
D

Other Details
e-

Applicants Details of Business Duration of Stay in West

Native State Native District
or service Bengal
NA NA
NA NA
Whether Applicant or Parents
Possess Any Immovable Whether Applicant Migrated
Property Like House etc. in Immovable Property Details from Any Other State or Reason for Application
West Bengal or in Any Other NA Country Other
State NA
NA
Other Reason for Application
Educational purpose

Generated on : 2023-12-26T11:33:19.874

P & AR Department,Government of West Bengal. All rights reserved. | Site Hosted By Webel Technology Limited (WTL). |Designed,developed,and
maintained by TATA Consultancy Services Ltd.
Version ID: 1.0 Beta | Site best viewed on Chrome/Firefox/Edge, on a 16:9 aspect ratio screen