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Bardan

The document is an Aadhaar enrolment form for an applicant named Bardan Basnet, detailing personal information such as name, date of birth, address, and appointment details. It outlines the required documents for identity, date of birth, and address verification, as well as the applicant's confirmation of residency and accuracy of information provided. The form also notes that enrolment is free and voluntary under the Aadhaar Act of 2016.

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Sanjeev Sarkar
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23 views1 page

Bardan

The document is an Aadhaar enrolment form for an applicant named Bardan Basnet, detailing personal information such as name, date of birth, address, and appointment details. It outlines the required documents for identity, date of birth, and address verification, as well as the applicant's confirmation of residency and accuracy of information provided. The form also notes that enrolment is free and voluntary under the Aadhaar Act of 2016.

Uploaded by

Sanjeev Sarkar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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AADHAAR ENROLMENT

FORM

(Aadhaar Enrolment is free &


भारतीय विशिष्ट पहचान प्राधिकरण भारत सरकार Voluntary)
Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES,
BENEFITS AND SERVICES) ACT,2016 (Aadhaar Act)
Submission Date : 28-02-
Application Type : Enrolment
2025
Applicant Details Appointment Details

Resident RESIDENT
Type:
Full Name: BARDAN BASNET
Date Of 25-02-2003
Birth/Age:
Address C/O Binod Basnet, C/13/ Bhujiapani,
Kolkata Road, Bagdogra, Near IAF
Camp Bagdogra, Bagdogra, Dakshin
Bagdogra, Bagdogra, Darjeeling ,
West Bengal, 734014
Email roy618412@gmail.com
Appointment Id: 1740723677451
Gender: Male Aadhaar Seva Ground floor, Mallar
Documents to Carry: Kendra Address:
Mukherjee Building,
Holding No.22/19/18. S.B.
Bring original documents for Sarani ward no. XI Rajni
Enrolment/Update. No photocopy Bagan(North), Siliguri,
required. West Bengal, Pin-734001
Original documents are scanned and Appointment
given back to you. 01-03-2025 (14:30)
Date and Time:
Carry/Bring appointment print copy.

Proof of identity:
Certificate issued on UIDAI Standard Certificate
format by: Gazetted Officer at NACO/ State Health
Department/ Project Director of the State Aids
Control Society or his nominee (in pursuance of
Honble Supreme Court Judgment in Criminal
Appeal No(s).135/2010 dated 19.05.2022)
Proof of date of birth:
Mark sheet/ Certificate issued by recognized Board
of Education/ University
Proof of address:
Certificate issued on UIDAI Standard Certificate
format by: Village Panchayat Head/ President or
Mukhiya/ Gaon Bura/ equivalent authority (for
rural areas)/ Village Panchayat Secretary/ VRO or
equivalent (for rural areas)
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 Applicant's Signature/Thumbprint


(Verifier must put her/his name if stamp is not
avaliable.)

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.

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