50 has / have not been included in the list. I apply for enlistment of his / her / their name(s) in the list. Ward No. Corporation /Municipality Enumeration Block No.– Address - Mobile No. (of any family member) – * In case of new born baby / change of place due to marriage or any other reason – birth registration no. or birth certificate or Card surrender and transfer certificate are mandatory. Signature of Applicant -----------------------------Return this portion to the Applicant----------------------------- Mention the name / names of the members of the family for whom Ration card are being sought for Father’s Name Mother’s Name Gend er EPIC no. or Aadhaar no. Date of Birth / Age (as on 1 st January of current year) Name of the Head of the family / member of the family who possesses the card of NFSA / RKSY NFSA / RKSY Card no. Type of Card (AAY / PHH / SPHH / RKSY-I / RKSY-II) State the relation between head of the family or the other card holders and the persons for whom card is being sought for (i.e. relation with the persons as mentioned in column no.5 & column no.1) State reason for non inclusion in the NFSA/RKSY list ( in case of new born baby/ change of places due to marriage/non enlistment in the SECC list/ in case of other reasons, state in details) *