AADHAAR

ENROLMENT FORM
Aadhaar Enrolment is free & Voluntary.

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

Submission Date : 09/08/2023 Application Type : NEW ENROLMENT

Application Details Appointment Details

SINORWALA NAJMABEN
Full Name:
MAHEBUBBHAI
Gender: FEMALE
DOB/Age: 30-06-1973
Address: , C/O, SINORWALA
MAHEBUBBHAI
ALLARAKHABHAI, 1, PAREDEIZ
SOCIETY,, SAMIR BAKERI
SAME, SALUN TALPAD,,
NADIAD, NADIAD, Salun Talpad,
Nadiad, Kheda, Gujarat - 387001
MUNNOVARVHORA@GMAIL.
Email ID:
COM
Mobile No.: +91-9998563440
Appointment ID: 1691601032303
Resident Type.: Indian Resident

Documents to Carry
1. POI: Voter ID
2. POA: Ration Card
3. DOB: PAN Card

I hereby confirm my identity and address as being true, correct and accurate.

Guardian/Relative Name: Signature of Guardian/Relative

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 & 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 his/her Name, if stamp is not available)

Note: In case of Child(< 5Yrs) or Guardian/Relative 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

Instructions
Please reach 15 min early at Aadhaar Seva Kendra and carry printed copy of this Application Form.
Do not damage the QR Code by folding the Application form across it.
Carry all the original Document(s) selected while filling up the form.
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.

List of POI Documents

1. Address Card having Name and Photo issued by

Department of Post
2. Arms License
3. Bank Pass Book having name and photo
4. Bhamashah Card
5. Certificate from Superintendent/ Warden/ Matron/ Head of
Institution of recognized shelter homes for orphanages,
homes etc on their official letter head
6. Certificate of Identity containing name and photo issued
by Recognized Educational Institution signed by Head of
Institute
7. Certificate of identity containing Name, DOB and
Photograph issued by Employees’ Provident Fund
Organisation (EPFO) on UIDAI standard certificate format
for enr
8. Certificate of Identity having photo issued by Gazetted
Officer or Tehsildar on letterhead
9. Certificate of Identity having photo issued by MP or MLA
or MLC or Municipal Councilor on UIDAI standard
certificate format for enrolment/ update
10. Certificate of Identity having photo issued by village
panchayat head or mukhiya or its equivalent authority (for
rural areas)
11. CGHS / ECHS Photo Card
12. Disability ID Card/handicapped medical certificate issued
by the respective State/UT Governments/Administrations
13. Driving License
14. Extract of School Records issued by Head of School
containing name and photo
15. Freedom Fighter Photo Card
16. Gazette notification for name change (with separately
affixed photo)
17. Government Photo ID Cards/ service photo identity card
issued by PSU
18. Kissan Photo Passbook
19. Marriage Certificate with photo
20. NREGS Job Card
21. PAN Card
22. Passport
23. Pensioner Photo Card
24. Photo Bank ATM Card
25. Photo Credit Card
26. Photo ID issued by Recognized Educational Institution
27. Ration/ PDS Photo Card
28. RSBY Card
29. School Leaving Certificate (SLC) / School Transfer
Certificate (TC), containing name and photo
30. SSLC book having candidates photo
31. ST/ SC/ OBC Certificate with photo
32. Voter ID

List of POA Documents

1. Address Card having Photo issued by Department of Post

 2. Allotment letter of accommodation issued by Central/State List of POR Documents
Govt. (not more than 3 years old)
3. Arms License 1. Address card having name and photo issued by
4. Bank Statement/Passbook Department of Post
5. Bhamashah card 2. Any other Central/State government issued family
6. Caste and Domicile Certificate having Photo issued by entitlement document.
State Govt. 3. Army Canteen Card
7. Certificate from Superintendent/ Warden/ Matron/ Head of 4. Bhamashah card
Institution of recognized shelter homes for orphanages 5. Birth Certificate issued by Registrar of Birth, Municipal
etc. on letter head Corporation and other notified local government bodies like
8. Certificate of Address having photo issued by MP or MLA Taluk, Tehsil etc.
or MLC or Gazetted Officer or Tehsildar on letterhead 6. Certificate of ldentity having photo and relationship with
9. Certificate of address having photo issued by Municipal HOF issued by village panchayat head or mukhiya or its
Councilor on letterhead equivalent authority (for rural areas)
10. Certificate of Address issued by Village Panchayat head 7. Certificate of ldentity having photo issued by MP or MLA or
or its equivalent authority (for rural areas) MLC or Municipal Councilor or Gazette Officer on
11. Certificate of Identity containing Name, Address and letterhead
Photo issued by Recognized Educational Institution 8. CGHS/State Government/ECHS/ESIC Medical card
signed by Head of Institute 9. Discharge card/ slip issued by Government hospitals for
12. Certificate of identity containing Name, DOB and birth of a child
Photograph issued by Employees’ Provident Fund 10. Marriage Certificate issued by the government
Organisation (EPFO) on UIDAI standard certificate format 11. NREGS Job Card
for enr 12. Passport
13. CGHS/ECHS Card 13. PDS Card
14. Credit Card Statement (not older than 3 months) 14. Pension Card
15. Disability ID Card/handicapped medical certificate issued
List of DOB Documents
by the respective State/UT Governments/Administrations
16. Driving License
1. Birth Certificate
17. Electricity Bill (not older than 3 months)
2. Central Government Health Service Scheme Photo Card
18. Extract of School Records containing Name, Address and
or Ex-Servicemen Contributory Health Scheme Photo card.
Photo issued by Head of School
3. Central/State Pension Payment Order
19. Freedom Fighter Card
4. Certificate of Date of Birth issued by Group A Gazetted
20. Gas Connection Bill (not older than 3 months)
Officer on Letterhead
21. Government Photo ID cards/ service photo identity card
5. Certificate of identity containing Name, DOB and
issued by PSU
Photograph issued by Employees’ Provident Fund
22. Income Tax Assessment Order
Organisation (EPFO) on UIDAI standard certificate format
23. Insurance Policy
for enr
24. Kissan Passbook
6. Certificate of Identity containing Name, DOB and Photo
25. ldentity Card issued by recognized educational institutions
issued by Recognized Educational Institution signed by
26. Marriage Certificate Issued by the Govt, containing name
Head of Institute
and address
7. Extract of School Records issued by Head of School
27. NREGS Job Card
containing Name, Date of Birth and Photo
28. Passport
8. Government issued certificate (or card) having photo and
29. Passport of Parents (in case of Minor)
duly signed by the signing authority
30. Passport of Spouse
9. Government Photo ID Card/ Photo Identity Card issued by
31. Pensioner Card
PSU containing DOB
32. Post Office Account Statement/Passbook
10. Mark sheet issued by any Government Board or
33. Property Tax Receipt (not older than 1 year)
Recognized University
34. Ration Card
11. PAN Card
35. Registered Sale/Registered Lease/Registered Rent
12. Passport
Agreement
13. Photo ID having Date of Birth issued by Recognized
36. School ldentity Card
Educational Institution
37. School Leaving Certificate (SLC) / School Transfer
14. School Leaving Certificate (SLC)/School Transfer
Certificate (TC), containing Name and Address
Certificate (TC), containing Name and Date of Birth
38. Signed Letter having Photo from Bank on letterhead
15. SSLC Book/Certificate
39. Signed Letter having Photo issued by Recognized
Educational Institution on letterhead or Photo ID having
address issued by Recognized Educational Institution.
40. Signed Letter having Photo issued by registered Company
on letterhead
41. SSLC book having photo
42. Telephone Landline Bill (not older than 3 months)
43. Vehicle Registration Certificate
44. Voter ID
45. Water bill (not older than 3 months)