Price: ` 1

Ration Card Modifications Application Form

Request Details
Ration Card No*:

Please check the below modifications if required

Address Change
Member Details Modifications

In Case of Present Address Change

House No. to be changed*:

Landmark/Locality/Colony to be changed*:
changed

District to be changed*:

Mandal to be changed*:

Ward/Village to be changed*:

Pin code to be changed *:

Wish to Change F.P Shop No*:
YES
NO

F.P Shop No. to be changed*(If Yes):

Proof Document of Present Address Change

Change*:
Driving License
Rental Agreement
Electricity Bill

Bank Pass book
LPG Receipt
Telephone Bill

Aadhar Card
Affidavit
Voter Id
Passport

In Case of Member Details Modifications

Name

DOB
(DD/MM/YYYY)

Gender

Father/Husband
Name

EID

UID

Relation with
Head

Reason for
Modifications

Informant Details
Informant Name*:

Relation*:

Mobile No*:

Delivery Type*:
Manual

Reason for House Hold Head Modifications*(Max 200 Characters):

Documents List
(NOTE: 1. All Upload Documents should be in PDF Format only 2. Each file should not exceed 50KB)
1.

Application Form*

2.

Proof for Address/Card Transfer *

3.

Proof for Member Modifications

Modifications*

Applicants Signature