अर्ज नमुना नं. ०३ - Suvidha Seva Kendra

www.sskindia.in

H$ë¶mUH$mar bmoH$emhrMm.... bmoH$m{^‘wI Moham....!

~MVJQ>mVrb {H$‘mZ B¶Îmm AmR>dr CÎmrU© g^mgXm§gmR>r

ñd¶§amoOJmamg àmoËgmhZmË‘H$ g~{gS>rgmR>rMm AO©

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‘hËdmMr gwMZm : ~MVJQ>m‘Ü¶o g^mgX Zgboë¶m H$moUË¶mhr ì¶³Vtg ñdV§ÌnUo gXa AO© H$aVm ¶oB©b.

www.sskindia.in n¥ð> H«$. 1

AO© Z_wZm Z§. 03

gw{dYm godm H|$ÐàYmZ H$m¶m©c¶ - Ý¶m¶m{Ye {ZdmgñWmZmOdi, nV§Jo {~ëS>tJ, {OOm‘mVm H$m°cZr, A{cnya amoS>,

~meu, {O. gmocmnya - 413411XÿaÜdZr : 09209637031/09209637125/09270360348/09272530288

09209637727/09209980829/09209637630/09209637052/09209637953g§Ho$VñWi : www.sskindia.in

E-mail : - [email protected]

09699520711, 07507953939

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gw{dYm godm H|$Ð H$ë¶mUH$mar bmoH$emhrMm bmoH$m{^‘wI Moham :-


AJXr gmoß¶m ̂ mfoV ñnïrH$aU Úmd¶mMo Pmë¶mg

nwdu AmnU amOoemhr amÁ¶ì¶dñWo‘Ü¶o amhV hmoVmo. VËH$m{bZ amÁ¶ì¶dñWo‘Ü¶o àOoH$Sy>Z

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g§ajU XoUo BV³¶mnwaVrM amÁ¶mMr g§H$ënZm ‘¶m©{XV hmoVr. nwT>o B§J«Om§À¶m AamOH$ amOdQ>rÀ¶m

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AmhþVr XoD$Z Amnbm Xoe ñdV§Ì Pmbm; Am{U AmnU bmoH$emhr amÁ¶ì¶dñWm pñdH$mabr. ¶m

amÁ¶ì¶dñWoMo à‘wI AmH$f©U åhUOo "H$ë¶mUH$mar amÁ¶mMr g§H$ënZm' (Concept of Welfare

State) Amnë¶m Hw$Qy>§~mV Á¶màH$mao nmbH$ Amnbr gd© O~m~Xmar d H$miOr KoVmV Ë¶m àH$mao H|$Ð d

amÁ¶ emgZmZo àË¶oH$ Hw$Qy>§~mg AÞYmÝ¶ {‘imdo, Amamo½¶ d BVa gmo¶r {‘imì¶mV BVHo$M Zìho Va

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ì¶º$s WoQ> emg{H$¶ H$m¶m©b¶mV AO© H$ê$ eH$Vo Va H$mhr ¶moOZm ¶m Zm|XUrH¥$V g§ñWm§‘m’©$V am~{dë¶m

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d gmXa H$amd¶mMo {R>H$mU, gj‘ A{YH$mar VgoM AO© XmIb Ho$ë¶mnmgwZ bm^ {‘iÊ¶mgmR>rMm

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Xbmb Am{W©H ZmJdUwH$ H$aVmV doioV Am{U H${Q>~ÜX (Time Bonding and

Committed) godm XoV ZmhrV. n[aUm‘r {d{dY H$ë¶mUH$mar ¶moOZm§À¶m bm^mg bm^mWu ì¶º$s d

g§ñWm nmÌ AgwZ Xo{Ib Ë¶m ¶moOZm§Mm bm^ KoVmZm Ag§»¶ AS>MUtZm Vm|S> Úmdo bmJVo Ë¶m‘wio "EH$mM

N>VmImbr d¡¶{º$H$ g§ñWmË‘H$ {d{dY H$ë¶mUH$mar' ¶moOZm§Mr g§nwU© Vn{ebdma ‘m{hVr nwa{dUmao d

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godm H|$ÐmMr ñWmnZm Ho$br AgwZ ~è¶mM g§ñWm d ì¶º$s "gw{dYm godm H|$ÐmÀ¶m' {d{dY gw{dYm§Mm bm^

KoV AmhoV.


{d{dY ñd¶§ amoOJmamgmRr {d{dY emg{H$¶ ¶moOZm d d¡Ym{ZH$ VWm ñdm¶Îm g§ñWm§‘m’©$V AW©ghmæ¶ VWm g~{gS>r AZwXmZ {‘i{dÊ¶mgmR>r gw{dYm godm H|$ÐmH$Sy>Z Vm§{ÌH$ ghmæ¶ {‘i{dÊ¶mgmR>rMm AOm©Mm Z‘wZm

à{V,‘m. ì¶dñWmn{H$¶ g§MmbH$,gw{dYm godm H|$Ð,Ý¶m¶m{Ye {ZdmgñWmZmOdi, nV§Jo {~ëS>tJ, {OOm‘mVm H$m°cZr, A{cnya amoS>,~meu, {O. gmocmnya - 413411

{df¶ :- ñd¶§ amoOJmamgmR>r {d{dY emg{H$¶ ¶moOZm d AÝ¶ emg{H$¶ g§ñWm§‘m’©$V AW©ghmæ¶ qH$dm g~{gS>rÀ¶m àH$ënmgmR>r gw{dYm godm H|$Ðm‘m’©$V àñVmd (Project Report) V¶ma H$ê$Z {‘iUo~m~V....

‘hmoX¶,Cnamoº$ {df¶mg§X^u g{dZ¶ {dZ§Vr Aer H$s, ‘bm ñd¶§amoOJmamgmR>r {d{dY emg{H$¶ ¶moOZm d BVa emgZ

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AO©Xma g§ñWm/ì¶º$sMo Zmd :Name of Applicant :

OÝ‘VmarI : D D M M Y Y Y Y

qbJ / Sex : Male Female

dS>rbm§Mo Zmd / nVrMo Zmd /(g§ñWm Agë¶mg AÜ¶jm§Mo/g{Mdm§Mo Zmd)

Father's Name / Spouse'Name

nÌì¶dhmamMm nÎmmCommunication Address :

1.

3.

4.

5.

6.

àñVm{dV ñd¶§amoOJmamÀ¶m (ì¶dgm¶mMm) ¶w{ZQ>Mm nÎmm : ( ) J«m‘rU ehar8.

Address of Proposed Location of Unit

{nZ H$moS>

B©-‘ob Am¶S>r7.

{XZm§H$ : / /2013

g§nH©$ H«$. XÿaÜdZr H«$.(EgQ>rS>r H$moS>gh)

20

0

(ì¶º$sJV AO©Xma Agë¶mg OÝ‘VmarI d g§ñWm AO©Xma Agë¶mg g§ñWoMm ñWmnZm {XZm§H$


e¡j{UH$ Ah©Vm :8.

e¡j{UH$ Vm§{ÌH$

BVa H$moUË¶mhr emg{H$¶ AWdm ImOJr {d^mJmMo ì¶mdgm{¶H$ à{ejU KoVbo Agë¶mg Ë¶mMr ‘m{hVr :9.

AO©XmamMm àdJ©11.

AZwgw{MV OmVr AZwgw{MV O‘mVr BVa ‘mJmg àdJ© em[a[aH$ ÑîQ>çm {dH$bm§J/An§J

‘mOr g¡{ZH$ Aëng§»¶m§H$ $C§M Q>oH$S>r/gr‘mdVu {Zdmgr gd©gmYmaU àdJ©

àH$ënmMm àH$ma : CËnmXZ godm ì¶dgm¶ (Manufacturing) (Business/Service Unit)

12.

àñVm{dV ì¶dgm¶ àH$mamMo Zm§d :13.

¶mnwdu BVa EImÚm emg{H$¶ H$m¶m©b¶mH$Sy>Z A{W©H$ ghmæ¶ AWdm g~{gS>r {‘imbr Agë¶mg Vn{eb14.

H$m¶m©b¶mMo Zmd Am{W©H$ ghmæ¶mMr a¸$‘ g~{g{S>Mr a¸$‘ df©

H$O© ‘mJUrMr àñVm{dV a¸$‘ 15. `

H$O© ‘mJUrMr àñVm{dV a¸$‘ Ajar :16.

godm ewëH$mÀ¶m YZmH$fm©Mm Vnerb : (Demand Draft Details)17.

Amount in words Demand Draft No. Branch of the bank

`

godm ewëH$mÀ¶m YZmH$fm©Mr a¸$‘(Demand Draft Amount)

godm ewëH$mMr a¸$‘ eãXmV YZmH$f© H«$‘m§H$ ~±H$ d emIoMo Zm§d

g§X^m©gmR>r ì¶dgm¶mMr ¶mXr n¥ï> H«$. 8,9 d 10 da Z‘wX Ho$br Amho. ¶mXr ì¶{V[aº$ ì¶dgm¶ {df¶ Agë¶mg Ë¶mMo ñdV§ÌnUo Zmd {bhmdo.

(godm ewëH$mgmR>r nmZ Z§.6 darb Vº$m nhm)

Proposed Loan Amount

10. ñdV:Mo ‘mbH$sMr eoVO‘rZ ñdV:Mo ‘mbH$sMr {~JaeoVrO‘rZ ì¶dgm¶mer {ZJ{S>V BVa ¶§Ìgm‘wJ«r~mJm¶V (EH$a)-{OamB©V (EH$a)-

Jw§R>o ehar -Jw§R>o J«m‘rU-


1.

2.

3.

4.

5.

6.

7.

?

AOm©gmo~V OmoS>md¶mÀ¶m Amdí¶H$ H$mJXnÌm§Mr ¶mXr

A.H«$. Vn{eb

e¡j{UH$ d Vm§{ÌH$ Ah©Vm à‘mUnÌ1.

AO©Xma 1) AZwgw{MV OmVr 2) AZwgw{MV O‘mVr 3) BVa ‘mJmg àdJ© 4) em[a[aH$ ÑîQ>çm {dH$bm§J/An§J 5) ‘mOr g¡{ZH$ 6) Aëng§»¶m§H$ 7) $C§M Q>oH$S>r/gr‘mdVu {Zdmgr àdJm©Vrb Agë¶mg Ë¶m~m~VMo gj‘ A{YH$mè¶mZo àXmZ Ho$bobo à‘mUnÌ

2.

AO©XmamZo àñVm{dV ì¶dgm¶mMo à{ejU KoVbo Agë¶mg Ë¶m~m~VMo à‘mUnÌ3.

5.

godm ewëH$ Vº$m(gw{dYm godm H|$ÐmÀ¶m Vm§{ÌH$ ghmæ¶mgmR>rMm {dZm naVmdm godm ewëH$)

OmoS>bo ( )Amho/Zmhr

A.H«$. àñVm{dV àH$ënmMr {ZYm©[aV a¸$‘godm ewëH$mMr a¸$‘

ê$. 50,000 Vo 1 bmI ê$. 1 bmI Vo 3 bmIê$. 3 bmI Vo 5 bmIê$. 5 bmI Vo 10 bmIê$. 10 bmI Vo 15 bmIê$. 15 bmI Vo 20 bmI ê$. 20 bmI Vo 50 bmI

AOm©gmo~V gw{dYm godm H|$ÐmH$Sy>Z(V¶ma Ho$bobm àñVmd pñdH$maVodoir)

3000/- ê$n¶o4000/- ê$n¶o4500/- ê$n¶o6000/- ê$n¶o 10000/- ê$n¶o15000/- ê$n¶o18000/- ê$n¶o

1000/- ê$n¶o800/- ê$n¶o1200/- ê$n¶o2000/- ê$n¶o6000/- ê$n¶o7000/- ê$n¶o8000/- ê$n¶o

‘hËdmMo : gw{dYm godm H|$ÐmÀ¶m godm ewëH$mÀ¶m aH$‘oMm YZmH$f© ({S>‘m§S> S´>mâQ>) AOm©gmo~V OmoS>bm Zgë¶mg gXa AOm©Mm {dMma Ho$bm OmUma Zmhr.AWdm H$gë¶mhr àH$maMm nÌì¶dhma Ho$bm OmUma Zmhr.

AO©XmamMr ñdmjar

{XZm§H$ :

darb gd© ‘OHy$a ~amo~a AgwZ Ë¶mVrb gË¶ AgË¶Vo ~m~VrV ‘r O~m~Xma Amho. Var àH$ën Ahdmb V¶ma H$ê$Z {‘imdm hr {dZ§Vr.

(AO© gmXa H$aVodoir)

eoV O{‘ZrMo d {~Ja eoVr O{‘ZrMo gÚ pñW{VVrb CVmao.4.


gw{dYm godm H|$ÐmH$Sy>Z gd© Vm§{ÌH$ godm KoÊ¶mgmR>rÀ¶m godm ewëH$mgmR>r 'Suvidha Seva Kendra ' ¶m Zmdo ~meu ¶oWo Xo¶ Agbobm (Payable at Barshi) {dZm naVmdm YZmH$f© ({S>‘m§S> S´>mâQ>) AWdm Am°ZcmB©Z no‘|Q> Q´>mÝg’$a H$aÊ¶mgmR>r ~±H$ Am°’$ B§{S>¶m emIm - ~meu, gw{dYm godm H|$Ð ImVo H«$‘m§H$ 071410110002612 (IFSC CODE - BKID0000714) ¶m ImË¶mda Ama.Q>r.Or.Eg. qH$dm EZ.B.E’$.Q>r. AWdm amoI ñdénmV ^éZ ^aUm Ho$ë¶mMr nmdVr gmo~V OmoS>mdr.(Imbrb godm ewëH$ V³Ë¶mà‘mUo.)

UNDERTAKING ON NON JUDICIAL STAMP WORTH RS.100/-

We the president and secetary of the ,organization mentioned as follows ;

Name of the organization ;-

Address :-

We hereby solemnly undertaking, that; I/We are applying to suvidha seva Kendra , That ; we have knowledge about the service charges of consulting and technical support are totally not refundable and free from claim of assurance means the Suvidha seva Kendra is only technical support and consulting service providing firm and not responsible for any type of rejection that which we have knowledge about all the eligibility norms of the said scheme. In case of bankable loan proposals; I/We are ready to communicate and co-ordinate with local branches of various banks, Suvidha seva kendra is not commited for bank loan sanctions. I/We have mentioned subject of subsidy proposal but as per the convenient to suvidha seva kendra as per our personal information provided in this application; Suvidha seva kendra may change subject of proposal or it's cost as they me fit. Suvidha seva Kendra is not responsible for the drastic major or minor change in the government scheme during the compliance of the project report work from the date of application and I/we do not claim about refund the sum paid for the same service. Fulfilment of the uncompleted documents or any type of queries if necessary of any project proposal /campaign/services that we are responsible to fulfil it within 10 days after received letter or message by any means of communication e.g. telefax, mobile, E-mail etc in case of delay to compliance of the querries or fulfilment of the document that late charges Rs. 10/- per day we I/will pay to suvidha seva Kendra and in case of delay suvidha seva Kendra is not responsible for any type of loss due delay of fulfilment of documents required for the govt. Scheme. We are not expending any type of funds before sanction from the government's competent authority. Jurisdiction for any type of litigation must be Mumbai, Dindoshi.

signature of applicant

UNDERTAKING FOR SERVICE OF SUVIDHA SEVA KENDRA

Date:


g§X^m©gmR>r {d{dY ì¶dgm¶m§Mr ¶mXr

A. gpìh©gog Am{U CÚmoJ1. H$Mè¶mnmgyZ ~JrMm V¶ma H$aUo.2. Am¶.³¶y.E’$.àH$ën

(‘m°b ‘Ü¶o ^mOrnmbm n°Ho$Q nya{dUo>)3. ‘¥X d Ob MmMUr à¶moJemim4. ggo nmbZ5. B©‘y nmbZ (ehm‘¥J)6. Mma MmH$s dmhZm§gmR>r godm H|$Ð7. nmZ XþH$mZ8. ^mV IaoXr H$aUo.9. Am°Q>mo bm°³g H$mpñQ>¨J10. Om°~ d³g©11. gm¡a CnH$aUo {dH«$s XþH$mZ12. Am°Q>mo Q>çyãO âb°ßg13. a~a JmñHo$Q>14. a~a ñQ>°åßg15. gm¡a Hy$H$a‘Ü¶o Imadbobo e|JXmUo16. H$‘r A§VamH$arVm Hw$arAa godm17. do~ S>oìhbn‘|Q>18. ‘mb dmhVyH$sgmR>r ñd¶§M{bV dmhZ19. gm°Bb d dm°Q>a Q>opñQ>¨J b°~20. Ho$~b Q>r.ìhr.21. Amdim Mhm22. {nH$mo ’$m°b23. {‘Zr H$m°b g|Q>a24. Amdim ga~V25. H$mOy ga~V26. H$moH$‘ ga~V27. Ymo~r godm28. ‘§S>n godm29. eoir nmbZ30. gmoba dm°Q>a {hQ>a V¶ma H$aUo.31. {‘Zr S>oAar32. H¥${f ~mOma d ‘m{hVr H|$Ð33. qMM nmdS>a V¶ma H$aUo.34. ‘±Jmo Á¶yg V¶ma H$aUo.35. gwHo$ A§Ora V¶ma H$aUo.36. Am°’$sg ’$mB©ëg V¶ma H$aUo.37. {S>ñQ´>rã¶weZ ~moS>©38. {d‘m ì¶dgm¶ godm39. H$m°B©b dmBªS>tJ40. OZab B§{O{Z¶a

41. {‘Zr bm¶~«ar42. E½O Aë~w‘rZ âb°³g43. ewJa ½bmoã¶wëg44. ’°$³g d B©-‘ob àjonU45. H$mnya dS>r V¶ma H$aUo.46. ~«mg ~±S>47. H«o$Z godm48. qb~y ga~V49. gm¶~a H°$’o$50. {’$aVo H$mnS> d H$nS>o {dH«$s XþH$mZ51. ~«oH$ S´>‘ H$mpñQ>¨J52. H$m§S>r H$moigm V¶ma H$aUo.53. JmoëS> q’$Ja V¶ma H$aUo.54. ñdrg {H«$g {g‘|Q> H$m¡bo V¶ma H$aUo.55. aoer‘ CÚmoJ 56. ~mOma ‘m{hVr H|$ÐmMr ñWmnZm H$aUo.57. H$mnS>r {neì¶m V¶ma H$aUo.58. {H«$‘ gonaoQ>a 59. M¸$m lrI§S> V¶ma H$aUo.60. bmH$S>r ’${Z©Ma V¶ma H$aUo.61. N>moQ>çm ~ë~À¶m gOmdQ>r ‘mim V¶ma H$aUo.62. ‘moQ>ma [adm¶S>tJ63. Q>mH$mD$ eoV‘mbmMm Cn¶moJ64. nmdS>a Am°{gS>°³Q>arZ65. ^m§S>r KmgÊ¶mgmR>r g’$mB© nmdS>a 66. amO{Jè¶mÀ¶m dS>çm67. gm¶H$b, nmZ d H°$a‘ XþH$mZ68. ASy>igm69. {M¸$s V¶ma H$aUo.70. ~m°bnoZ V¶ma H$aUo.71. ~wÉ>r Ho$ ~mb (Candy Floss)72. Jm§Sy>i IV V¶ma H$aUo73. {H$amUm ‘mb d ^mOrMo XþH$mZ74. gmS>rMm ’$m°b V¶ma H$aUo75. A§~mS>r ga~V76. {M¸y$ ‘odm77. Q>obg© bo~b V¶ma H$aUo.78. Q>mo‘°Q>mo Ho$Mn V¶ma H$aUo.79. noßgr H$mobm gmaIo {eVno¶ V¶ma H$aUo.80. eVmdar H$ën V¶ma H$aUo.81. {b’$m’o$ V¶ma H$aUo.82. XþMmH$s d Mma MmH$s dmhZ YwbmB© H|$Ð


82. gmS>rbm {nH$mo-’$m°b H$aUo.83. ^mVmMr {JaUr84. {H$amUm XþH$mZ d {nR>mMr {JaUr85. KaJwVr ImUmdi 86. Zg©ar àH$ën87. dm¶Zar àH$ën88. ’$im§Mm ‘wam§~m V¶ma H$aUo89. dZm¡fYr dZñnVr bmJdS>90. bmøm CËnmXZ àH$ën (nm°nH$m°Z©)91. AmYw{ZH$ gwVmaH$m‘92. ~°qQ>J ½bmoìhO CËnmXZ H$aUo93. KaJwVr CnH$aUm§Mr Xþê$ñVr94. EbnrOr {gb|S>agmR>r A°ë¶w{‘{Z¶‘ grb95. ’w$beoVr 96. ~mH$adS>r V¶ma H$aUo.97. ‘wa‘wao V¶ma H$aUo.98. {eHo$H$mB© V¶ma H$aUo.99. erVJ¥ho (H$moëS> ñQ>moaoO)100. Q>m¶qnJ101. ñWm{ZH$ d XÿañW S>mQ>m EÝQ´>r H$aUo102. Ea§S>rMo Vob103. Om{hamV H$bm (Advertisement)

104. {b³drS gmon V¶ma H$aUo.105. ZmMUrMo gËd106. bmoH$arMo H$nS>o V¶ma H$aUo.107. {dÚwV godm Vk (Electrician)

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113. Q>o{bH$m°‘ g§~§{YV godm114. gwJ§{YV gwnmar àH$ën115. {dÚwV CnH$aUo Xþê$ñVr116. gwYm[aV {ZY©ya Myb117. Bìh|Q> ‘°ZoO‘|Q>118. {’$aË¶m J«mhH$m§gmR>r ’°$³g d B©-‘obMr godm119. {~ñH$sQ>o V¶ma H$aUo.120. AJa~Îmr V¶ma H$aUo.121. XÿaÜdZr ~wW 122. ‘³¶mMo Vob V¶ma H$aUo.123. b±Q>o³g a~a H§$S>moåg124. Z³erXma H$m‘ H$aUo.

125. g|Q>atJ godm (Jd§S>r H$m‘mVrb ñb°~ C^maUo dJ¡ao)

126. newImÚ V¶ma H$aUo.127. nm°nH$m°Z© V¶ma H$aUo.128. pìhS>r¶mo g|Q>a129. d¡¶{º$H$ g§JUH$ XoI^mb H§$ÌmQ> 130. N>§Xm‘YyZ {d{dY ì¶dgm¶131. pìhS>r¶mo eyQ>tJ godm132. ^mOrnmbm gwH${dUo133. B§Oo³eZ ‘moëS>oS> eyO (~wQ>)134. YmÝ¶mMr àVdmar R>a{dUo135. d¡¶{º$H$ g§JUH$mMr dm{f©H$ XoI^mb136. S>mogm^Å>r137. ’$moQ>mo’«o$‘138. ‘iUr¶§Ì139. H$m§XmMmir140. Ym½¶m§Mo ari141. {ZaJwS>rMo Vob V¶ma H$aUo.142. H$nS>çm§Mm gm~U V¶ma H$aUo.143. nwê$fm§Mo H$nS>o {edwZ V¶ma H$aUo.144. AmB©ñH«$s‘ MZ©a145. Am°Q>mo‘mo~mB©b J°aoO146. {àQ>tJ àog147. ’$aí¶m§Zm nm°{be H$aUo.148. ~m§~wÀ¶m dñVy V¶ma H$aUo.149. ßb°pñQ>H$ nmQ>©g150. amondm{Q>H$m g§JmonZ151. H$m°qH«$Q> {‘³ga godm152. ñd¶§M{bV XþMmH$s dmhZ Xþê$ñVr d XoI^mb153. dZg§nÎmr ‘m{hVr H|$Ð 154. H$~©¶wº$ erVno¶o (gmoS>m dm°Q>a)155. ßbmñQ>rH$ ‘moëS>tJ156. ZmaimÀ¶m nmZmnmgyZ PmSy> V¶ma H$aUo.157. ñd¶§M{bV dmhZm§‘Ü¶o J«rg ^aUo.158. N>m¶m{MÌU159. ’$moQ>moJ«m’$s160. Ia~yOmÀ¶m d gy¶©’y$bmÀ¶m {~¶m161. ÐmjmMo ga~V162. gwVù¶m§Mr nmoVr V¶ma H$aUo.163. H$S>^mHw$Å>r ¶§Ì164. H$m°H«$sQ>Mo R>moH$io ~Z{dUo.165. ~m§JS>çmMo {’$aVo XþH$mZ166. dmhZm§gmR>r YwbmB© H|$Ð167. ‘mo~mB©bgmR>r {ZHo$b H°$S>{‘¶‘ ~°Q>ar


168. ~¡bm§H$arVm Km§Jar nÅ>m169. Am¶wd¡{XH$ gwJ§Yr VobmMo CËnmXZ170. Q>mMÊ¶m§Mo CËnmXZ171. ’°${~«Ho$eZ CËnmXZ172. H$m°åß¶wQ>a ^mS>çmZo XoUo173. Am¶wd}{XH$ amonm§Mr Zg©ar174. Am¶wd}{XH$ amonm§Mr Zg©ar175. Am¶wd}{XH$ àgmYZo176. H$m°åß¶wQ>a à{ejU XoUo177. ì¶m¶m‘emim178. agm¶Z{dahrV Jwi179. ^wB©‘yJmÀ¶m e|Jm ’$moS>Uo180. {S>hmS´>oQ>oS> H°$aoQ> loS>g181. ìhÀ¶w©Ab ng©Zb d Am°{’$g A{gñQ>§Q>182. hmQ>uH$ëMa p³b{ZH$183. ßb°pñQ>H$Mo Ádobar ~m°³g V¶ma H$aUo184. ã¶wQ>rnmb©a185. H$mJXnÌm§Mo B© H$mJXnÌm§‘Ü¶o ê$nm§Va H$aUo.186. H$m°åß¶wQ>ada AH$m¢Q>g {bhUo187. H$S>YmÝ¶m§nmgyZ S>mi188. n|Q>a189. ~Z ‘oH$s¨J190. H$m°Q²>g ~oS> {nbmo {Z{‘©Vr191. ‘§S>n S>oH$moaoeZ192. Am°Q>mo gpìh©g g|Q>a193. Bbo³Q´>m°{Z³g [anoAg©194. KS>çmi Xþê$ñVr195. ’$moQ>mo ñQw>{S>Amo196. gmo’$m [ano[a¨J d³g©197. MmXa {dUZo198. n¡R>Ur V¶ma H$aUo.199. npãbH$ Q´>mÝgnmoQ>© gpìh©gog (dmhZ IaoXr)200. ê$ab Q´>mÝgnmoQ>© (JwS²>g H$[aAa)201. h~©b ã¶wQ>r nmb©a202. gm¶H$b XþH$mZ203. ñào n|qQ>J204. S>r. Oo gmD$S> {gñQ>r‘205. Q>m¶a ìhmoëH°$Zm¶qOJ ¶w{ZQ>206. S>rOob B§{OZ n§n goQ> [anoAa H$aUo.207. ßb§q~J208. ~m~©a209. bm°ÝS´>r

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H$. ’$m°aoñQ> ~og ì¶dgm¶1. H$mÏ¶m CËnmXZ2. ~mñHo$Q>/~°J V¶ma H$aUo.3. ’$m‘m© àmoS>³Q> V¶ma H$aUo.4. ‘Yw ‘jrH$m nmbZ.5. ~m§~wÀ¶m dñVw V¶ma H$aUo.6. bmI V¶ma H$aUo.7. Jwèhmi8. qS>H$ V¶ma H$aUo.9. Ywn AJa~Îmr CËnmXZ 10. ~Znmd ‘oH$s¨J ¶w{ZQ>11. BVa


CËnmXZ ì¶dgm¶

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B©. A°J«mo Am{U ’w$S> CÚmoJ1. AmB©g ~m°³g V¶ma H$aUo.2. Idm Am{U M¸$m ¶w{ZQ>3. W«oqeJ 4. ^wB©‘wJ CËnmXZ (Vob Am{U {~¶m§gmR>r)5. erVno¶ / noßgr ¶w{ZQ>6. gmoS>m ‘°Z’°$³M[a¨J àmoS>³Q>g7. ~oXmZm B§S>pñQ´> grS²>g àmogoqgJ8. nmohm ‘oqH$J ¶w{ZQ²>g / nm°nH$moZ©9. gwnmar ‘oqH$J ¶w{ZQ²>g10. Zmai Am{U gwnmar CËnmXZ11. Ho$ir / ~Q>mQ>çmMo do’$g© V¶ma H$aUo.12. BVa AÞ {Z{‘©Vr CÚmoJ13 ~oH$ar àmoS>³Q>g14. AmB©g H°$ÝS>r CËnmXZ15. ‘gmbm CÚmoJ16. nmnS> CÚmoJ17. agd§Vr18. ñdrQ²>g CËnmXZ19. VmS>r CËnmXZ CÚmoJ20. amB©g {‘b21. Xmb {‘b22. {nR>mMr {JaUr / âbmoAa {‘b23. eod¶m CËnmXZ24. ‘oh§Xr CËnmXZ25. Jwam§Mo ImÚ V¶ma H$aUo.26. XþYmnmgwZ àmoS>³Q>g V¶ma H$aUo.27. H$mOw à{H«$¶m CÚmoJ28. ‘H$m àmogoqgJ ¶w{ZQ>29. VobmMm KmUm30. ’$io Am{U emH$mhma àmogoqgJ ¶w{ZQ>

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अर्ज नमुना नं. ०३ - Suvidha Seva Kendra

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Transcript of अर्ज नमुना नं. ०३ - Suvidha Seva Kendra