SSIN : 135038018733
Form 2
Card-Cum-Pass Book for Provident Fund under BM-SSY Unorganized Workers
Name of Gram Panchayat / Ward No : sahapur
Block / Municipality /Municipal Corporation : Rampurhat-II
District : Birbhum
1. Name of Beneficiary : MOUSUMI LET
2. Husband’s Name : NRIPEN LET
3. Permanent Address : BLOCK/MUNICIPALITY/CORPORATION : Rampurhat-II ,
P.S : Tarapith ,
P.O : Poprasahapur B.O,
PIN CODE : 731233,
GP/WARD : sahapur,
VILLAGE/STREET/ROAD : VILL- SAHAPUR, PO- POPARA SAHAPUR, PS - TARAPITJ, DIST - BIRBHUM, PIN - 731233
4. Present Address : BLOCK/MUNICIPALITY/CORPORATION : Rampurhat-II ,
P.S : Tarapith ,
P.O : Poprasahapur B.O,
PIN CODE : 731233,
GP/WARD : sahapur,
VILLAGE/STREET/ROAD : VILL- SAHAPUR, PO- POPARA SAHAPUR, PS - TARAPITJ, DIST - BIRBHUM, PIN - 731233
5. Date Of Birth : 02-07-1983
6. Date of Approval in the BM-SSY : 05-08-2024
7. SSIN : 135038018733
Date Of Maturity On Name & Address Relationship With Age
Attaining Age Of 60 Years Of The Nominee(S) The Subscriber Of Nominee(S) Status
01-07-2043 SANNYASI LET Son 18 Active
Subscription Made
Month & Year For
Which Signature Of
Sl No. Subscription Is Made Book No Receipt No Date Of Collection Amount Collecting Agent/SLO
Signature of the Registering Authority Signature of the Holder
07-08-2024 14:08:60