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Registration Form For Issuing Id Cards For Colony Animal/Birds Care Takers

This document contains a registration form for issuing ID cards to colony animal/bird caretakers from the Animal Welfare Board of India. The form requests information such as the applicant's Aadhaar card number, name, date of birth, address, contact details, identity proof documents, and photos. It also requires a recommendation from a member of the Animal Welfare Board of India or related organization. Upon completion, the applicant must sign declaring that the provided details are true.

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Sambasivam Ganesan
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788 views2 pages

Registration Form For Issuing Id Cards For Colony Animal/Birds Care Takers

This document contains a registration form for issuing ID cards to colony animal/bird caretakers from the Animal Welfare Board of India. The form requests information such as the applicant's Aadhaar card number, name, date of birth, address, contact details, identity proof documents, and photos. It also requires a recommendation from a member of the Animal Welfare Board of India or related organization. Upon completion, the applicant must sign declaring that the provided details are true.

Uploaded by

Sambasivam Ganesan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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ANIMAL WELFARE BOARD OF INDIA

(Ministry of Environment, Forest & Climate Change, Govt. of India)


National Institute of Animal Welfare Campus 42 KM Mile
Stone,
Delhi-Agra Highway
NH-2, Ballabhgarh, Haryana - 121004
Phone No: 0129- 2555608
E-mail: awbi@md3.vsnl.net.in; animalwelfareboard@gmail.com
Website: www.awbi.org

REGISTRATION FORM FOR ISSUING ID CARDS FOR COLONY ANIMAL/BIRDS CARE TAKERS
(Please fill in capital letters)

1) Aadhaar Card ID No. 2508 6996 1296 :


(enclose self attested copy) PHOTO

2) Name of the applicant : S GANESSANE RIVIERE

3) Date of Birth (Age as on date) : 08.02.1958

4) Blood Group O POSITIVE

5) Complete address with Pin Code : NO 11,FIRST CROSS STREET,

SURIYAGHANDHI NAGAR
MUTHIAL PET POST
PUDUCHERRY-605003

6) Contact No. (Telephone/Mobile/email/ 9367600108 rivgan58@gmail.com


Whatsapp) :

7) Provide any one of the following having Latest address proof and photo identity :
(Copy of Ration Card/ Voter ID/Driving
License/Passport/Pan Card etc which is to be self attested)

8) Please provide two passport sized photos

9) Recommended by :

(Member, AWBI/Co-opted Member, AWBI/


State Animal Welfare Board/ District Collector/
District Animal Husbandry Officer/
District SPCA )

I ____________________________ S/o or D/o or W/o _____________________________ do

hereby declare that the details given above are true to the best of my knowledge.

( )

Signature of the Applicant


Signature of the Applicant (Required for ID card printing purpose)
(For office use only)
1. Application No. :
2. Date of receipt of Application : 3. Date of issuance of ID Card :

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