1910112028, 2055 aboutblank ~ 8 AADHAAR UPDATE FORM s AD v. rcaaierorevatteen acer AADHAAR Cer Secon sf THE SADITAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT20I6 (Aaa AG) 378425714170 Application Type : UPDATE Submission Date : 13-01-2023 Fields to be updated in Aadhaar: *Only fields mentioned here will be updated at ASK center. ‘Appointment Detail Resident Type: RESIDENT YEDURI MADHAVI (C/O Yeduri Pydiraju, 38-30-52! sainagar lane-6, New brilliant school, Marripalem, ‘Visakhapatnam (Urban), Visakhapatnam (urban), Visakhapatnam , Andhra Pradesh, 530018 r ’ 1. Bring original documents for Enrolment/Update Appointment as 1673623438459 ‘No photocopy required. Aadhaar Seva Plot No.47-11-16, Shop No 404 2. Original documents are seanned and given back to || Kendra Address: and 405. Grant Palace, Ist Lane, Loy Dwarka Nagar, Besides Sarover Proof of address Hotel, Visakhapatnam-530016 Trourmcs Poy Life & Medial only) Appointment Date 46.91.2025 (10:0) Service Type: Demographic Update ( Address, ) Payment Typs Online Payment Status: Success Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND. OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT, 2016 1 confirm that Ihave been residing in India for atleast 182 days in the preceding 12 months / am Non Resident Indian (NR) & information (including biometrics) provided by me to the UIDAL is my own and is true, correct and accurate. Lam 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 ageney only with my consent during authentication or as per the provisions of the ‘Aadhaar Act. Thave 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 i stamp is not avalible.) 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. List of Documents Instructions 1. Please reach 15 min early at Aadhaar Seva Kendra and carry printed copy of this Application Form. 2. Cary all the Document(s) selected while filling up the form, about lank M41910112028, 2055 serve you betier next time. aboutblank 3. Get the printed copy of final application form before leaving the center. Also, please fill the feedback form atthe exit counter to List of POL Documents List of POA Documents Pensioner Photo Card/Freedom Fighter Photo Card RATION/ PDS PHOTO CARD. DRIVING LICENSE KISSAN PHOTO PASSBOOK Bank Pass Book having name and Photograph Cross Stamped by bank official ARMS LICENSE ST/SCIOBC certificate with Photo PASSPORT School Leaving Certificate (SLC) School Transfer Certificate (I Extract of School Records issued by Head of School! SSLC book’ SSC certificateMark Sheet issued by board’ University containing name and photograph 10, PHOTO BANK ATM CARD 11. Disability ID Card handicapped medical certificate issued by the respective Central State/ UT Governments 12, Voter ID/ e-Voter ID 13, Photo ID Cardi Certificate with photo issued by Cental/State Govt, like Bhamashah, Domicile Certificate, Resident Certificate, Jan-Aadhaar, MGNREGA/ NREGS Job card ete 14, Mariage certificate with photograph issued by State/Central Govt 15, CGHS/ ECHS/ ESIC! Medi-Claim Card with Photo issued by State/ Central Govts,/ PSUs! Rashtriya Swasthya Bima Yojana (RSBY) Card 16, PAN Cardi e-PAN 17. Service photo identity card issued by Central Govt./State Govt/ UT Govt PSU! Banks 18, Certificate from Superintendent’ Warden! Matron’ Head of Institution of recognized shelter homes or orphanages etc ‘on UIDAI standard certificate format for enrolment/update 19, Certificate of Identity having photo issued by MP or MLA ‘or MLC or Municipal Councilor on UIDAI standard certificate format for enrolment/ update 20, Certificate of Identity having photo issued by Village Panchayat Head or Mukhiya or its equivalent authority for rural areas on UIDAI standard certificate format for cenrolment/ update 21. Transgender ID card/ Certificate issued under the Transgender Persons (Protection of Right) Act, 2019 22. Certificate of Identity issued on UIDAL standard certificate format for enrolment/ update by: Recognized Educational Institution signed by Head of Institute 23. Valid Long Term Visa (LIV) along with Foreign Passport (valid or expired) of origin country issued to minorities communities of Afghanistan, Bangladesh and Pakistan ramely Hindus, Sikhs, Buddhist, Jain, Parsis and Christians 24. Valid Visa along with Foreign Passport (valid only) issued in ease of other Foreign Nationals who has stayed in India| for 182 days or more in the 12 months 25. Centficate of Identity issued on UIDAL standard certificate format for enrolment/ update by: Tehsildar/ Gazette about blank 1. Bank Statement (with Bank stamp & signature of bank official) Passbook/ Post Office Account Statement! Passbook 2. WATER BILL (NOT OLDER THAN 3 MONTHS) 3. ARMS LICENSE 4. CGHS) ECHS! ESIC/ Medi-Claim Cs issued by State! Central Govts,/ PSU: 5. Allotment letter of accommodation issued by Central/State Govt. of not more than 3 years old 6. Service photo identity card issued by PSU! Banks! State! Central Governments 7. Disability ID Card/ handicapped medical certificate issued by the respective State/ UT Governments! Administrations! Central Govt, with Photo 8. Insurance Policy (Life & Medical only) 9, SIGNED LETTER HAVING PHOTO ISSUED BY RECOGNIZED EDUCATIONAL INSTITUTION ON LETTERMIEAD 10. Voter IDY e-Voter ID 11. Electricity Bills (not older than 3 months) including. prepaid receipts 12, Telephone Landline Bill/ Phone (Postpaid Mobile) Bill Broadband Bill (not older than 3 months) 13. DRIVING LICENSE 14, School Leaving Certificate (SLC) School Transfer ‘entficate (TC) Extract of School Records issued by Head of School/ SSLC book’ SSC eertficate containing same and Address 15. Gas Connection Bill( not older than 3 months) 16, Photo ID Card/ Certificate having address issued by Central/State Govt. like Bhamashah, Domicile Centficate, Resident Certificate, Jan-Aadhaar, MGNREGA/ NREGS Job card ete 17. Marriage Certificate issued by the Government containing Name and address 18, Pensioner Cardi Freedom Fighter Cat 19, KISSAN PASSBOOK, 20, RATION CARD 21, Certificate of Address issued on UIDAI standard certificate format for enrolment’ update by: Tehsildar! Gazetted Officer Group ‘A'/ Gazetted Orficer Group “BYEPEO Officer 22, PROPERTY TAX RE YEAR 23. Registered Sale/ Registered Rent Agreemen Gift Deed duly register by Registrar office 24, Cenlficate of Address issued on UIDAI standard certificate format for enrolment! update by: Superintendent’ Wardea/ Matron’ Head of Institution of recognized shelter homes or orphanages 25, Passport 26. Valid Visa (if comprises of Indian address) along with Foreign Passport (valid only) issued in case of other IPT NOT OLDER THAN | Registered 261910112028, 2055 Officer Group “AY/Gazetted Officer Group 26, For Exception cases of Gender Change: Medical Certificate from allopathie doctors incase resident changed gender surgically 21. Valid School Identity cara Photo ID issued by Recognized| Educational Institution (during study course time ie. while nthe rolls only) 28. For Full name/first name change requests: Resident to submit the Gazette notification of new name along with any supporting Pol document of old name with photograph (Even for Ist instance of the Full namelfirst name change) 29, For Exception cases of Name Change: Divorce Dectoe 30. For Exception cases of Name Change: Adoption certificate List of DOB Documents |. Marksheet issued by any recognized Government Board or University School Leaving Certificate (SLC) Sehool Transfer Certificate (TC) Extract of School Records issued by Het ‘of School! SSLC book’ SSC certificate containing Name and Date of Birth PAN Card/e-PAN Central! State Pension Payment Order BIRTH CERTIFICATE PASSPORT Photo 1D card having Date of Birth, issued by Recognized Educational Institution 8. Exception cases of DoB Change: Resident to submit self declaration as per notified format 9. Valid Long Term Visa (LTV) along with Foreign Passport (valid or expired) of origin country issued to minorities communities of Afghanistan, Bangladesh and Pakistan namely Hindus, Sikhs, Buddhist, Jain, Parsis and Christians 10, Transgender ID card! Certificate issued under the Transgender Persons (Protection of Right) Act, 2019 11. Certificate of Identity having Name & DoB issued on UIDAL standard certificate format for enrolment update by: Recognized Educational Institution signed by Head of Institute 12, Certificate of Wentity having Name & DoB issued on | UIDAT standard certificate format for enrolment update by: Gazetted Officer Group °A'/ EPFO officer 13. Service photo identity card issued by Central Govt.State Govt/UT Govt/PSU/Banks 14, CGIIS) ECHS! Medi-Claim Card issued by Centre’ State UTs Gouts PSUs having with Photo & Date of Birth List of POR Documents 1, PENSION CARD. 2, Ration card/PDS Card 3. Discharge card slip issued by Government/ Private hospitals for birth of a child (only for child aged between (0-5 years) 4, MARRIAGE CERTIFICATE ISSUED BY THE GOVERNMENT about blank aboutblank Foreign Nationals who has stayed in India for 182 days ot ‘more in the 12 months 27, Centficate of Address issued on UIDAI standard certificate format for enrolment/ update by: Recognized Educational Institution signed by Head of Institute 28. Transgender ID card/ Certificate issued under the Transgender Persons (Protection of Right) Act, 2019 29. Valid Long Term Visa (LTV) along with Foreign Passpor (valid or expired) of origin country issued to minorities communities of Afghanistan, Bangladesh and Pakistan namely Hindus, Sikhs, Buddhist, Jain, Parsis and Christians 30, Certificate of Address issued on UIDAI standard certificate format for enrolment! update by: MP/ MLA/ MLC! Municipal Councilor 31. Centficate of Address issued on UIDAI standard certificate format for enrolment! update by: Village Panchayat Head of Mukhiya or its equivalent authority (for rural areas) Village Panchayat Secretary or VRO or equivalent (for rural areas) 32. Valid School Identity card/Tdentity Card issued by recognized educational institutions (during study course ime ie. while on the rolls only) 31910112028, 2055 1. Mask is mandatory at all the times when the resident isin or around the ASK Centre 2. It is advised for the resident to have Aarogya Setu Mobile App installed in their mobile, The current status will be viewed by the 3. Ifpossible it is advised to residents not to travel from hotspot zone. 4. It is advised to the residents to follow all the precautionary measures instructed at the ASK while availing the services. ANY OTHER CENTRAL/STATE GOVERNMENT ISSUED FAMILY ENTITLEMENT DOCUMENT (CGHS/ ECHS/ ESIC/ Meéi-Claim Card with Photo issued by Centre’ State Govis/ PSUs BIRTH CERTIFICATE ISSUED BY REGISTRAR OF BIRTH, MUNICIPAL CORPORATION AND OTHER, NOTIFIED LOCAL GOVERNMENT BODIES LIKE TALUK, TEHSIL ETC. Photo ID card issued by Central/ State Govt. like 'Bhamashah, Jan-Aadhaar, MGNREGA card, ARMY canteen card ete Self declaration from the Head of Family (HoF) certifying the relationship with the resident residing atthe same address as HoF uideline to follow at ASK Center ASK Centre guard atthe entrance gate, aboutblank about lank 4