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) Moina Das Paresh Das 25,000/- 172 150 21 1338 NEW APL Labour 6 Shifali Das Pratap Das 40,000/- 172 486 115 1339 NEW APL House Wife 2 Lakhi Davi Sadap Lt. M.Suran 20,000/- 170 91 20 1340 NEW APL Housewife 1 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. 1338 NEW APL Moina Das Paresh Das Labour 25,000/- 6 172 150 21 1339 NEW APL Shifali Das Pratap Das House Wife 40,000/- 2 172 486 115 1340 NEW APL Lakhi Davi Sadap Lt. M.Suran Housewife 20,000/- 1 170 91 20 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 .