Certificate For Purcshasing/selling Cash Foreign Currency And Checks

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ONLINE APPLICATION
FRESH
RENEWAL
DUPLICATE
Rs. 250
Rs. 150
Rs. 100
GOVERNMENT OF INDIA
INDIA POST
Application for Proof of Address Card
Please write the BLOCK LETTERS
1. Name of the applicant:
Please affix
1(a). Nationality
recent
stamp size
colour
2. Name of Father / Husband / Parent / Guardian / Other Relative (Please mention relationship):
photograph
3. Date of Birth (dd/mm/yyyy):
4. Current Postal Address with PIN Code:
5. Permanent Postal Address with PIN Code (if different from serial 4):
6. Date since residing in the address at serial 4:
7. If you are a tenant, please furnish particulars (address / telephone number / mobile number / email id) of the landlord or flat / apt owner's association:
8. Particulars of Employment identity (if employed), Please attach photo copy of ID card issued by the employer:
9. Address of the employer with email id:
Email id of the employer : ______________________________________________
(Please turn overleaf)

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