New User Application Form
ATTENTION: Dr. Subrata Chattopadhyay
Personal Information
Title: Mr. Miss. Mrs. Other_________________ Gender: Male Female
Full Name: ____ ________________________________________________________________________________________
Photo ID card no: ____ _____ Position: ___________________________
Organization: ___ ______________________________________
Address: _ _
Telephone: _____ ___ Mobile: ____ ____ Fax: ______ _______
Email: _______ _______________________
SERIAL No.______________________________________ (‘Serial no.’ from Online Registration Form)
Subscriber Signature: ________________________________ Date: __ __/____/_____ (DD/MM/YYYY)
Registration Authority Section (To be filled by RA)
Approve Reject
Identification Document: Photo ID card
Comment: ______________________________________________
RA Name: _______________________________________________
RA Organization: __________________________________________
RA Signature: ________________________ Date: ____/____/____ (DD/MM/YYYY)
CAO Section: Result Certificate
Issue Complete
Reject
**Note: Photo ID card - ((Passport, PAN card, Work ID or Driver’s License)
CAO signature: ______________
Date: ____/____/____ (DD/MM/YYYY)
________________________________________________________________________________________
Contact Information
IGCA Garuda Grid Operation Centers Certificate Authority,
#1, CDAC Knowledge Park,
Old Madras Road, Byappanahally, Bangalore – 560 038, INDIA.
Tel. +91-80-25246353, 080-66116511 Fax. +91-80-2524 7724
Contact IGCA Manager : igca@cdac.in
