Government Of Rajasthan - Email Account Creation Application Form - Single User
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1
2Government of Rajasthan
Department of Information Technology & Communications
EMAIL ACCOUNT CREATION APPLICATION FORM – SINGLE USER
(Please read the instructions in given at Page No. 2 of this application form. Please fil the form in BLOCK/ CAPITAL
LETTERS only and the filled application form, both the pages duly signed and stamped by the applicant and HOO of
the concerned department, should be submitted to Email Administrator, DoIT&C, Room No. 308, IT Building, Yojna
Bhawan Campus, Tilak Marg, C-Scheme, Jaipur-302016 and copy of same may be sent through email at
helpdesk.email@rajasthan.gov.in
or mailadm@rajasthan.gov.in) failing which the A/c shall be de-activated.
*All fields are mandatory
Name
Mr/ Ms/ Dr.
Designation
Department/ Org.
Office Address
Telephone (O)
Mobile No.
+91-
Personal Email Address
Date of Retirement/
Date of Birth
/
/
/
/
Contract End Date
Email Address Type
[
] Name based
[
] Designation based
Preferred Email
1.
@RAJASTHAN.GOV.IN
Address (20 char. Max.
2.
@RAJASTHAN.GOV.IN
before @)
Note: The Email address will be generated based on the availability and DoIT&C naming policy. The ID
should not be used for sending personal/ promotional/ marketing mails but official communication only.
DoIT&C shall not be responsible for the content of the mails being delivered through gateway/ server. I
hereby declare that I have thoroughly read the terms and conditions overleaf and I agree to abide by them.
Signature of the Applicant with Seal
Date:
Approval of HOO with Seal/ Sign.
--- For Office Use Only ---
Account Type
[
] FREE
[
] PAID
Email ID Created
Remarks (if any)
Signature of In-charge/ OIC (Mail Services) with Name & Designation
(v1.1)
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