Name of GPSS/WCCS …………………………………………………………………………………… Name of nearest Fair price Shop Dealer…………………………………………………………. Type of F.C.I As per recent voter list of Photograph of Performa- Card no. of Annual Card (for BPL/ Occupation of the Total assembly election C & check existing FIC Women applicant family Name of women applicant number of Father/ Husband Name Head of the family Sl No. list Holder or MMASY/ (under NFSO) family (size 3.5 cm)X 2.5 income registration mention new as per Performa- C members PS No. SL No. House No. declared APL Card Cm) no. applicant Holder only) Itie Das Dilip Das 20,000/- 171 406 73 1341 NEW APL Housewife 5 Nirupama Gogoi Lt. Rajen Singh 30,000/- 170 455 96 1342 NEW APL Housewife 2 Singh Rahima Begum Abdul Tainal 7,000/- 172 669 131 1343 NEW APL Worker 5 SELECT LIST OF ELIGIBLE HOUSE HOLDS UNDER NSFSO 2013 Diphu Name of LAC:- 19 Diphu (ST) LAC Name of District :- Karbi Anglong Name of Sub –Division:- Name of village/municipal /Town Ward:- Ward No. 3 Targeted Population……………………………………….. No.& Name of Gaon Panchayat ………………………………………….. Name of Development Block………………………………………………………………….. ….. Name of Revenue Circle:- Diphu .
Name of GPSS/WCCS …………………………………………………………………………………… Name of nearest Fair price Shop Dealer…………………………………………………………. Sl No. Performa- C & check list registration no. Card no. of existing FIC Holder or mention new applicant Type of F.C.I Card (for BPL/ MMASY/ APL Card Holder only) Name of women applicant (under NFSO) Father/ Husband Name Occupation of the Head of the family as per Performa- C Annual family income declared Total number of family members As per recent voter list of assembly election Photograph of Women applicant (size 3.5 cm)X 2.5 Cm) PS No. SL No. House No. 1341 NEW APL Itie Das Dilip Das Housewife 20,000/- 5 171 406 73 1342 NEW APL Nirupama Gogoi Singh Lt. Rajen Singh Housewife 30,000/- 2 170 455 96 1343 NEW APL Rahima Begum Abdul Tainal Worker 7,000/- 5 172 669 131 SELECT LIST OF ELIGIBLE HOUSE HOLDS UNDER NSFSO 2013 Name of LAC:- 19 Diphu (ST) LAC Name of District :- Karbi Anglong Name of Sub –Division:- Diphu Name of village/municipal /Town Ward:- Ward No. 3 Targeted Population……………………………………….. No.& Name of Gaon Panchayat ………………………………………….. Name of Development Block………………………………………………………………….. ….. Name of Revenue Circle:- Diphu .