**/**/****

*/*

भ रत य व श पहच न धकरण भ रत सरक र

AADHAAR UPDATE FORM

Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT,2016 (Aadhaar Act)

Submission Date : 07-08-2020 Aadhaar Number : 750********* Application Type : UPDATE Fields to be updated in

Aadhaar:

[Name, Mobile, Biometric(photo/fingerprint/Iris)]*

*Only fields mentioned here will be updated at ASK center. Applicant Details

Resident Type: RESIDENT

Full Name: MUSTA FIZUR RAHMAN UROOJ

New Full Name: MUSTAFIZUR RAHMAN UROOJ

Mobile Number: 974-***-****

Documents to Carry:

Proof of identity: VOTER ID

Appointment Details

Appointment Id: 159**********

Aadhaar Seva

Kendra Address:

Asyst Park, Salt Lake, Sector-v,

Block GN-37/1, Kolkata-700091

Appointment Date

and Time: 16-08-2020 (11:10)

Service Type: Biometric and Demographic Update (

Name, Mobile,

Biometric(photo/fingerprint/Iris) )

Payment Type: Online

Payment Status: Success

Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT, 2016

I confirm that I have been residing in India for at least 182 days in the preceding 12 months / I am Non Resident Indian (NRI) & information (including biometrics) provided by me to the UIDAI is my own and is true, correct and accurate. I am aware that my information including biometrics will be used for generation of Aadhaar and authentication. I understand that my identity information

(except core biometric) may be provided to an agency only with my consent during authentication or as per the provisions of the Aadhaar Act. I have a right to access my identity information (except core biometrics) following the procedure laid down by UIDAI. Verifier's Stamp and Signature

(Verifier must put her/his name if stamp is not avaliable.) Applicant's Signature/Thumbprint

Note: In case of Child(< 5 Yrs) or Guardian based application, Guardian/Relative will be required to accompany the applicant. In case of incapacitated person, the signature will be done by Legal Guardian of Incapacitated Person. List of Documents

Instructions

1. Please reach 15 min early at Aadhaar Seva Kendra and carry printed copy of this Application Form. 2. Carry all the Document(s) selected while filling up the form. 3. Get the printed copy of final application form before leaving the center. Also, please fill the feedback form at the exit counter to serve you better next time.

07/08/2020

2/4

List of POI Documents

1. PASSPORT

2. RATION/ PDS PHOTO CARD

3. PAN CARD

4. GOVERNMENT PHOTO ID CARDS/ SERVICE PHOTO

IDENTITY CARD ISSUED BY PSU

5. VOTER ID

6. NREGS JOB CARD

7. DRIVING LICENSE

8. PENSIONER PHOTO CARD

9. PHOTO BANK ATM CARD

10. ARMS LICENSE

11. PHOTO CREDIT CARD

12. PHOTO ID ISSUED BY RECOGNIZED

EDUCATIONAL INSTITUTION

13. FREEDOM FIGHTER PHOTO CARD

14. KISSAN PHOTO PASSBOOK

15. CGHS / ECHS PHOTO CARD

16. ADDRESS CARD HAVING NAME AND PHOTO

ISSUED BY DEPARTMENT OF POSTS

17. Certificate of Identify having photo issued by Gazetted Officer or Tehsildar on letterhead

18. Disability ID Card/handicapped medical certificate issued by the respective State/UT Governments/Administrations 19. Bhamashah Card

20. Marriage Certificate with Photograph

21. Gazette Notification for name change

22. ST/SC/OBC certificate with Photo

23. Certificate of Identity having photo issued by MP or MLA or MLC or Municipal Councillor on letterhead

24. Certificate of identity having photo issued by village panchayat head or Mukhiya for rural areas.

25. SSLC Book having candidates Photograph

26. RSBY Card

27. Certificate from Superintendent/ Warden/Matron/ Head of Institution of recognized Shelter Homes for Orphanages, Homes etc.

28. Extract of School Records issued by Head of School containing name and photograph

29. School Leaving Certificate (SLC)/ School Transfer Certificate (TC), containing name and photograph

30. Bank Pass Book having name and photograph

31. Certificate of Identity containing name and photograph issued by Recognized Educational Institution signed by Head of Institute on UIDAI standard certificate format for enrolment/ update.

32. Certificate of identity containing Name, DOB and Photograph issued by Employees? Provident Fund

Organisation (EPFO) on UIDAI standard certificate format for enrolment/ update

List of DOB Documents

1. A certificate or ID Card having photo and Date of Birth

(DOB) duly signed and issued by a Government authority List of POA Documents

1. POST OFFICE ACCOUNT STATEMENT/PASSBOOK

2. BANK STATEMENT/PASSBOOK

3. VOTER ID

4. PASSPORT

5. RATION CARD

6. DRIVING LICENSE

7. TELEPHONE LANDLINE BILL (NOT OLDER THAN

3 MONTHS)

8. GOVT PHOTO IDENTITY CARD/SERVICE PHOTO

IDENTITY CARD ISSUED BY PSU

9. ELECTRICITY BILL (NOT OLDER THAN 3

MONTHS)

10. WATER BILL (NOT OLDER THAN 3 MONTHS)

11. PROPERTY TAX RECEIPT NOT OLDER THAN 3

MONTHS

12. CREDIT CARD STATEMENT (NOT OLDER THAN 3

MONTHS)

13. SIGNED LETTER HAVING PHOTO FROM BANK ON

LETTERHEAD

14. INSURANCE POLICY

15. SIGNED LETTER HAVING PHOTO ISSUED BY

REGISTERED COMPANY ON LETTERHEAD

16. ARMS LICENSE

17. SIGNED LETTER HAVING PHOTO ISSUED BY

RECOGNIZED EDUCATIONAL INSTITUTION ON

LETTERHEAD

18. NREGS JOB CARD

19. PENSIONER CARD

20. FREEDOM FIGHTER CARD

21. KISSAN PASSBOOK

22. CGHS / ECHS CARD

23. CERTIFICATE OF ADDRESS HAVING PHOTO

ISSUED BY MP OR MLA OR MUNICIPAL

COUNCILLOR OR GAZETTED OFFICER OR

TEHSILDAR ON LETTERHEAD

24. Certificate of Address issued by Village Panchayat head or its equivalent authority (for rural areas)

25. Income Tax Assessment Order

26. Registered Sale / Lease /Rent Agreement

27. 2Vehicle Registration Certificate

28. Address Card having Photo issued by Department of Posts

29. Caste and Domicile Certificate having Photo issued by State Govt

30. Disability ID Card/handicapped medical certificate issued by the respective State/UT Governments/Administrations 31. Gas Connection Bill( not older than 3 months)

32. Passport of Spouse

33. Passport of Parents (in case of minor)

34. Allotment letter of accommodation issued by

Central/State Govt. of not more than 3 years old

35. Marriage Certificate issued by the Government

containing address

36. Bhamashah Card

07/08/2020

3/4

2. Photo ID card having Date of Birth, issued by Recognized Educational Institution

3. PASSPORT

4. SSLC BOOK/CERTIFICATE

5. PAN CARD

6. School Leaving Certificate (SLC)/ School Transfer Certificate (TC), containing Name and Date of Birth 7. Extract of School Records issued by Head of School containing Name, Date of Birth and Photograph

8. Mark sheet issued by any Govt. Board or University 9. Certificate of Identity containing Name, DOB and Photograph issued by Recognized Educational Institution signed by Head of Institute LIST OF ACCEPTABLE

SUPPORTING DOCUMENTS FOR VERIFICATION 5th

September, 2019

10. CERTIFICATE OF DATE OF BIRTH ISSUED BY

GROUP A GAZETTED OFFICER ON LETTERHEAD

11. BIRTH CERTIFICATE

12. Govt. Photo ID Card/ Photo Identity card issued by PSU containing DOB

13. Central/ State Pension Payment Order

14. Central Govt. Health Service Scheme photo card or Ex- Servicemen Contributory Health Scheme photo card

15. Certificate of identity containing Name, DOB and Photograph issued by Employees? Provident Fund

Organisation (EPFO) on UIDAI standard certificate format for enrolment/ update

List of POR Documents

1. MNREGA JOB CARD

2. PDS CARD

3. PENSION CARD

4. ARMY CANTEEN CARD

5. PASSPORT

6. CGHS/STATE GOVERNMENT/ECHS/ESIC MEDICAL

CARD

7. ANY OTHER CENTRAL/STATE GOVERNMENT

ISSUED FAMILY ENTITLEMENT DOCUMENT

8. BIRTH CERTIFICATE ISSUED BY REGISTRAR OF

BIRTH, MUNICIPAL CORPORATION AND OTHER

NOTIFIED LOCAL GOVERNMENT BODIES LIKE

TALUK, TEHSIL ETC.

9. MARRIAGE CERTIFICATE ISSUED BY THE

GOVERNMENT

10. Address Card having Name and Photo issued by

Department of Posts

11. Discharge Card/Slip Issued by Govt. Hospitals for Birth of a Child

12. Bhamashah Card

13. Certificate of identity having photo and relationship with HOF issued by village panchayat head or mukhiya (for rural areas)

14. Certificate of identity having photo issued by MP or MLA or MLC or Municipal Councillor or gazette officer on letterhead

37. Certificate from Superintendent/ Warden/Matron/ Head of Institution of recognized Shelter Homes for orphanages, homes etc on letter head.

38. Certificate of address having photo issued by municipal councillor on letter head.

39. Identity card issued by recognised educational institutions 40. School identity card

41. SSLC Book having Photograph

42. School Leaving Certificate (SLC)/ School Transfer Certificate (TC), containing Name and Address

43. Certificate of Identity containing Name, Address and Photograph issued by Recognized Educational Institution signed by Head of Institute

44. Extract of School Records containing Name, Address and Photograph issued by Head of School

45. Certificate of identity containing Name, DOB and Photograph issued by Employees? Provident Fund

Organisation (EPFO) on UIDAI standard certificate

format for enrolment/ update

Guideline to follow at ASK Center

07/08/2020

4/4

1. Mask is mandatory at all the times when the resident is in or around the ASK Centre. 2. It is advised for the resident to have Aarogya Setu Mobile App installed in their mobile. The current status will be viewed by the ASK Centre guard at the entrance gate.

3. If possible it is advised to residents not to travel from hotspot zone. 4. It is advised to the residents to follow all the precautionary measures instructed at the ASK while availing the services.

Contact this candidate