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    Application

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    sabatkunal75
    laoima

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    Application

    Uploaded by

    sabatkunal75
    1 views2 pages
    laoima

    Original Title

    Application (11)

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    laoima

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1 views2 pages

    Application

    Uploaded by

    sabatkunal75
    laoima

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Application for Grant of Financial Assistance for Inter­Caste Marriage

    Payment Details

    Receipt Number Transaction Id


    ICMTRN2504202427168 ICM2504202422871

    Amount Paid Transaction Date


    ₹59.00 25­Apr­2024 03:58:48

    Paid to CSC as convenience charges

    Sumangal Registration No : Applied By

    SUM10582 Husband

    Email Mobile No.

    [email protected] 9124062640

    Details of Husband Details of Wife

    Full Name of Husband Aadhar Card Number. Full Name of Wife Aadhar Card Number.
    ANUP KUMAR SANA XXXX XXXX XXXX 9449 SANGITA BEPARI XXXX XXXX XXXX 0615

    Full Present Address Full Present Address

    Address Address

    AT ­POURBELLA 2 PO­ TURUDIHI PS ­ KUNDEI AT ­POURBELLA 2 PO­ TURUDIHI PS ­ KUNDEI

    City Block City Block


    RAIGHAR RAIGHAR RAIGHAR RAIGHAR

    District Pin District Pin


    NAWARANGPUR 764074 NAWARANGPUR 764074

    State State
    Odisha Odisha

    Permanent Address (before marriage) Permanent Address (before marriage)

    Address Address
    AT ­POURBELLA 2 PO­ TURUDIHI PS ­ KUNDEI AT ­BADAKUMARI­UV 1 PO­ BADAKUMARI PS ­ UMERKOTE

    City Block City Block


    RAIGHAR RAIGHAR UMERKOTE UMERKOTE

    District Pin District Pin


    NAWARANGPUR 764074 NAWARANGPUR 764073

    State State
    Odisha Odisha

    Other Information Details

    Occupation of husband Monthly income of Husband Occupation of wife Monthly income of wife
    CULTIVATION 10000.00 HOUSE WIFE 0.00

    Who belongs to SC category Sub caste of SC Husband Date Of Birth Wife Date Of Birth

    Wife Namasudra 06­Mar­1991 06­Jan­2000

    Has the marriage has been


    Actual Date Of Marriage Marriage Registration No Marriage Registration Date
    registered?
    23­Aug­2018 221361500002 24­Jan­2022
    Yes

    Registration Office Name


    Registration Date Is it 1st marriage of Husband? Is it 1st marriage of wife?
    UMERKOTE SUB­REGISTRAR
    24­Jan­2022 Yes Yes
    OFFICE

    If not are they widow / Has any body of them


    widows? received the grant earlier? Mention the Grant Date

    No No

    Bank Information Details

    Account Number Bank Name Branch IFSC Code


    7659000100104537 PUNJAB NATIONAL BANK UMERKOTE PUNB0765900

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