0% found this document useful (0 votes)
6K views7 pages

सावित्रीबाई फुले किशोरी समृद्धि योजना

This document appears to be an application form for benefits under the Sukanya Samriddhi Yojana scheme in Jharkhand for girl children. The form requests information such as the applicant's name, address, date of birth, school/education details, bank account information, parents' names and identification numbers. It also asks the applicant to specify which class/age category they fall under to receive benefits and whether they are currently receiving any other government benefits. Declarations are required from the parent/guardian certifying that the information provided is accurate.

Uploaded by

Anand Shukla
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
0% found this document useful (0 votes)
6K views7 pages

सावित्रीबाई फुले किशोरी समृद्धि योजना

This document appears to be an application form for benefits under the Sukanya Samriddhi Yojana scheme in Jharkhand for girl children. The form requests information such as the applicant's name, address, date of birth, school/education details, bank account information, parents' names and identification numbers. It also asks the applicant to specify which class/age category they fall under to receive benefits and whether they are currently receiving any other government benefits. Declarations are required from the parent/guardian certifying that the information provided is accurate.

Uploaded by

Anand Shukla
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
You are on page 1/ 7

>kj[k.

M ljdkj
efgyk] cky fodkl ,ao lkekftd lqj{kk foHkkx
lkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk gsrq vkosnu izi=
vkosfndk dk
QksVks

1. vkosfndk dk uke@irk:
uke&......................................................................................................................................

ekrk@firk@vfHkHkkod dk uke&............................................................................................

xzke&......................................................................................................................................

iapk;r dk uke&.....................................................................................................................

iz[k.M@uxj fuxe@uxj iapk;r@uxj ifj"kn&.....................................................................

ftyk dk uke&........................................................................................................................

2. vkaxuokM+h dsUnz dk uke ,oa dksM la0 ¼;fn Kkr gks½&.........................................................


3. vkosfndk dh fooj.kh%
I. tUe frfFk :
a. tUe izek.k i= dh la[;k
¼Nk;kizfr layXu½
b. ernkrk igpku i= dh la[;k ¼Nk;kizfr layXu½
¼;fn 18&19o"kZ ds ykHk gsrq vkosnu lefiZr gS½
II. fookfgr@vfookfgr :

III. vkosfndk dk tUe Øe : izFke iq=h f}rh; iq=h


¼bl vk'k; gsrq Lo?kks"k.kk i= lefiZr djuk gksxk½

IV. vkosfndk dk vk/kkj la[;k :

V. vkosfndk dk cSad@iksLV vkWfQl [kkrk la0 ,oa fooj.kh%


a. iksLV vkWfQl@cSad [kkrk la[;k :
b. iksLV vkWfQl@cSad dk uke :
c. 'kk[kk dk uke%
d. IFSC Code%
4. vkosfndk ds ekrk@firk dk uke%
¼vkosfndk dh ekrk dh e`R;q dh fLFkfr esa firk dk uke ,oa vfHkys[k ekU; gksxkA ekrk dk e`R;q izek.k i= layXu djuk
vfuok;Z gksxk½

Page 1 of 7
5. vkosfndk ds ekrk@firk dk vk/kkj la0 :
¼vkosfndk dh ekrk dh e`R;q dh fLFkfr esa firk dk vk/kkj la[;k ekU; gksxk½
6. vfHkHkkod dk uke ¼vukFk vkosfndk dh fLFkfr esa½:

7. vfHkHkkod dk vk/kkj la0 :


¼vukFk vkosfndk dh fLFkfr esaekrk@firk dk e`R;q izek.k i= ,oa cky dY;k.k lfefr }kjk fuxZr vukFk laca/kh izek.k i=
lefiZr fd;k tkuk vfuok;Z gS½

8. vkosfndk ds fo|ky; dk uke] irk ,oa fdl laLFkk ls ekU;rk izkIr gS%
¼tgk¡ ykxw gks½
a. fo|ky; dk uke ,oa irk :

b. fdlh laLFkk ls ekU;rk ikIr gS :

c. d{kk :
d. lsD'ku :
e. jksy uEcj :

9. vkosfndk ds ykHk izkfIr dk oxZ%


Øe oxZ okafNr ykHkqd oxZ ij fVd yxk,¡ ()
¼i½ d{kk&VIII esa ukekafdr ckfydk :

¼ii½ d{kk&IX esa ukekafadr ckfydk :

¼iii½ d{kk&X esa ukekafadr ckfydk :

¼iv½ d{kk&XI esa ukekafadr ckfydk :

¼v½ d{kk&XII esa ukekafadr ckfydk :

¼vi½ 18&19 o"kZ dh ckfydk :

10. vkosfndk ds ekrk@firk jkT;@dsUnz ljdkj : gk¡ ugha


esa LFkk;h :i ls fu;ksftr@lsokfuo`r@isa'ku@
ikfjokfjd isa'ku izkIr djus okys ugha gksa rFkk
vkosfndk ds ekrk@firk vk;djnkrk ugha
gks] laca/kh izek.k i=
¼ekrk@firk ds }kjk Lo?kks"k.kki= lefiZr fd;k tk,xk½

11. fnO;kax ckfydk dh fooj.kh ¼;fn ykxq gks rks½ :


a. fnO;kaxrk dk izdkj :
b. fnO;kaxrk dk izfr'kr :
c. izek.k i= la0 ,oa frfFk :
¼Nk;kizfr layXu½

Page 2 of 7
12. D;k vkosfndk dks eq[;ea=h lqdU;k ;kstuk : gk¡ ugha
dk ykHk izkIr gS
¼;fn gk¡ rks fooj.k nsaA ,d ls vf/kd esa Hkh fpUg yxk ldrs gS½

tUe ls nks o"kZ d{kk&VIII mÙkh.kZ 18&20 o"kZ dh ;qorh


d{kk&I esa ukekafdr d{kk&XmÙkh.kZ
d{kk&V mÙkh.kZ d{kk&XII mÙkh.kZ

13. vkosfndk dks eq[;ea=h y{keh ykMyh ;kstuk dk fdrus fdLr dk ykHk izkIr gS:

?kks"k.kk
izekf.kr fd;k tkrk gS fd Åij nh xbZ lHkh lwpuk,¡ lgh gSa ,oa fn, x, fdlh Hkh xyr lwpuk ds fy, eSa Lo;a
ftEesokj gksšxh@gksšxkA eSa viuk vk/kkj u0 viuh LosPNk ls bl ;kstuk dk ykHk izkIr djus gsrq miyC/k dj
jgh@jgk gw¡A

¼vkosfndk ds ekrk@vfHkHkkod dk gLrk{kj½ ¼vkosfndk dk gLrk{kj½


uksV% &
1- lkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk vUrxZr ykHk] ekrk dh izFke nks iqf=;ksa dksns; gksxkA
2- ;kstuk ds vUrxZr ljdkjh@vuqlwfpr tutkfr] vuqlwfpr tkfr] vYila[;d ,oa fiNM+k oxZ dY;k.k foHkkx@efgyk] cky
fodkl ,oa lkekftd lqj{kk foHkkx >kj[k.M ljdkj }kjk lapkfyr@National Child Labour Project/>kj[k.M ljdkj }kjk
izcaf/kr@vuqnkfur fo|ky;ksa esa v/;;ujr vgZrk/kkjh Nk=kvksa dks vkPNkfnr fd;k tk,xkA
3- ;kstuk ds ykHkkFkhZ ckfydkvksa ds ekrk&firk dsUnz ljdkj@jkT; ljdkj@dsUnzh; lkoZtfud {ks= ds miØeksa@jkT;
lkoZtfud {ks= ds miØeksa esa LFkk;h :i ls fu;ksftr@lsokfuo`r@isa'ku@ikfjokfjd isa'ku izkIr djus okyk rFkk
vk;djnkrk ugha gksuk pkfg,A
4- ekrk dh e`R;q dh n'kk esa ekrk dk e`R;q izek.k i= dh Nk;kizfr ,oa firk ds lacaf/kr vfHkys[k vko';d gSA
5- vukFk ykHkqd dh n'kk esa ikyd ekrk&firk@CWC }kjk tkjh izek.k i=@laLFkk dk lapkyd tgk¡ ckfydk fuokl djrh
gks dks vfHkHkkod ds :i esa ekU;rk nh tk,xhA
6- lanfHkZr lHkh izek.k i=ksa dh Li"V Nk;kizfr layXu fd;k tkuk vfuok;Z gksxkA

Page 3 of 7
Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq vkosfndk dh ekrk dk Lo?kks"k.kk i=

vkosnu izi= ds dafMdk&3 dk iii ds vkyksd esaA

¼ekrk dh e`R;q dh fLFkfr esa firk dk ?kks"k.kk i= ekU; gksxk½

eSa --------------------------------------- ¼vkosfndk dh ekrk½ firk&------------------------------------------ xzke&--------------------------------

Á[k.M ---------------------------------------Fkkuk& -------------------------------------------- ftyk &-----------------------------------------------------------------------

dh fuoklh gw¡A eSa LovfHkÁekf.kr djrh gw¡ fd Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstukUrxZRk vkosnu djus

okyh esjh iq=h ---------------------------------------------------------------------- ¼vkosfndk dk uke½ ÁFke@f}rh; iq=h gSA esjs }kjk

nh xbZ lwpuk iw.kZr% lR; gS] fdlh Hkh Lrj ij tk¡p ds Øe esa xyr ik;s tkus ij eSa Lo;a nks"kh ekuh

tkšxhA xyrh ik, tkus ij esjh iq=h dks ;kstuk ds ykHk ls oafpr fd;k tk ldrk gSA

vkosfndk dh ekrk dk gLrk{kj

Page 4 of 7
Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq vukFk ckfydkvksa gsrq Áek.k&i=

¿vkosnu izi= ds dafMdk&6 ,oa 7 ds vkyksd esaÀ


i=kad& -----------------------
fnukad& ---------------------

Áekf.kr fd;k tkrk gS fd ---------------------------------------------------------------------- ¼vkosfndk dk uke½ dh tSfod ekrk ----

--------------------------------------------------------------- ,oa tSfod firk ---------------------------------------------------------------- dk nsgkUr gks pqdk

gSA vkosfndk ---------------------------------------------------------------------------- ds ikyu iks"k.k dk nkf;Ro Jh@Jherh

¼nkf;Roxzkgh dk uke ,oa irk½------------------------------------------------------------------- irk ---------------------------------------------------------------

----------------------------------------------------------------------------- dks lkSaik x;k gSSA vkosfndk ----------------------------------------------------------

dks Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq Áek.k&i= fuxZr fd;k tkrk gSA

cky dY;k.k lfefr dk gLrk{kj

Page 5 of 7
Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq vk; laca/kh Lo?kks"k.kk i=

vkosnu izi= dh dafMdk&10 ds vkyksd esaA

¼ekrk dh e`R;q dh fLFkfr esa firk dk ?kks"k.kk i= ekU; gksxk½

eSa --------------------------------------- firk@ifr&------------------------------------------] vkosfndk&--------------------------------------------------- dh

ekrk@firk gw¡ ,oa xzke&-------------------------------Á[k.M --------------------------------------- Fkkuk& ----------------------------------------------------------

ftyk &-------------------------------------- dh fuoklh gw¡A

1- eSa ,oa esjs ifr vk;djnkrk ugha gaSA

2- eSa Lo;a vFkok esjs ifr dsUnz ,oa jkT; ljdkj vFkok dsUnzh;@jkT; lkoZtfud {ks= ds miØeksa esa LFkk;h

#i ls fu;ksftr@lsokfuo`r vkSj isa'ku@ikfjokfjd isa'ku ÁkIr ugha dj jgsa gSA

eSa Lo vfHkÁekf.kr djrh gw¡ fd esjs }kjk mijksDr rF; lR; vafdr fd;s x, gSaA fdlh Hkh Lrj

ij tk¡p ds Øe esa xyr ik;s tkus ij eSa Lo;a nks"kh ekuh tkÅ¡xhA xyrh ik, tkus ij esjh iq =h dks ;kstuk ds

ykHk ls oafpr fd;k tk ldrk gSA

vkosfndk dh ekrk@firk dk gLrk{kjA

Page 6 of 7
Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq lacaf/kr fo|ky; ds Á/kkukpk;Z }kjk lR;kiu Áek.k&i=

vkosnu izi= dh dafMdk&8 ,ao 9 ds vkyksd esaA

i=kad& -----------------------
fnukad& ---------------------

Áekf.kr fd;k tkrk gS fd ---------------------------------------------------------------------------------------------------------- ¼Nk=k dk uke½

firk&------------------------------------------------ xzke&--------------------------- Á[k.M& ------------------------------- Fkkuk& ------------------------

ftyk& --------------------------------------------------------- jkT;& >kj[k.M dh fuoklh gSA ;g fd Nk=k fo|ky;& ----------------

------------------------------------------------------------------------ ¼fo|ky; dk uke½ esa d{kk& ------------------ esa ukekafdr gSA bUgsa

Lkkfo=hckbZ Qqys fd'kksjh le`f) ;kstuk ds ykHk gsrq fo|ky; esa v/;;ujr gksus laca/kh lR;kiu

Áek.k&i= fuxZRk fd;k tkrk gSA

Á/kkukpk;Z dk gLrk{kj
Á/kkukpk;Z dk uke --------------------------------
fo|ky; dk uke -----------------------------------
Á[k.M ------------------------------------------------------
ftyk -------------------------------------------------------

Page 7 of 7

You might also like