Hindustanwelfare

Services/Financial Assistance

Financial Assistance Form Application

(All States of India)

PART-I

Service Name *

Applicant's Name *

S/D/W/o *

Date of Birth *

Gender *

Mobile No *

Email ID *

PART-II

Address for Communication

Address 1 *

Address 2

Address 3

Pincode *

District *

State *

Nationality *

PART-III

Please Select Out of the Following Documents Which You Have:-

PART-IV

(SELF DECLARATION)

That I am a citizen of India. That I have neither acquired the citizenship of another country nor have surrendered or been terminated or deprived of my citizenship of India. I further declare that I fulfill all the conditions of eligibilities. I have read the provisions of the Notice of this application carefully and I hereby undertake to abide by them. I have not submitted any other application before. I am aware that if I contravene this rule my application will be rejected summarily by the SAMITI.

I do not have any criminal record. That no warrant or summons has been issued by any court of India against me. I do hereby solemnly and sincerely declare that I have never been convicted of any crime or offense and I am not involved in any kind of criminal or unlawful activity and no criminal or any unlawful activity case is currently pending against me. I hereby state that the facts mentioned above are true to the best of my knowledge and belief. I agree All Terms & Conditions.

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HINDUSTAN JAN KALYAN RASHTRIYA VIKAS SEWA SAMITI

Administrative Autonomous Organization under Govt. Of India
National Capital Territory of Delhi

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