FORM No.1

 

(See Rule 5 )

 

Application from for registration under the E.G.S.

 

To,

          The Registering Authority,

          .............................................

          .............................................  

          Village..................................

          Panchayat Samiti..................

 

 

Sir,

 

          I request you to register my name as an employment seeker under the Employment Guarantee Scheme.My particulars are as below :

l.Name-

2. Address-

3.Name of Caste if belonging to

   S.C.,S.T.Vimukta Jati or Nomadic

          Tribe.

 

4.Sex:Male/Female-

 

5. Age-

 

6.Land holding,if any,in hectares.

 

 

Date-..........

Place..........           Signature /Thumb Impression of applicant.