Fill in Senior Citizen Card Application

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Senior Citizen Card Application

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Your details
Age and residence
Filing the application

Step 1 of 3

Your details

The office you are applying to, as named by that officeNeeded

For example: the office named on the portal or at the counter

Your full nameNeeded

For example: Harbhajan Singh

You are theNeeded

Your father's or husband's or wife's nameNeeded

For example: Sh. Mohinder Singh

Your addressNeeded

House / flat / plot no.

Street, sector or locality

City area and PIN code

Your Aadhaar numberNeeded

For example: XXXX XXXX 1234

Your mobile numberNeeded

A number somebody can be reached on. Ten digits is the usual Indian form, and a country code in front of it is fine if you want it there.

For example: 98765 43210

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APPLICATION FOR A SENIOR CITIZEN CARD

To
The Officer-in-charge,
__________.

Subject: Application for issue of a Senior Citizen Card

Sir/Madam,

I declare as follows:

(a) My date of birth and age are as stated above, and are shown by the proof of age I enclose.

(c) Every statement in this application is true to my knowledge and belief. I understand that the card may be refused or cancelled if any statement is found false.

I enclose:

(1) proof of my age;
(2) proof of my residence;
(3) passport-size photographs, if the office requires them;
(4) the fee, if any, that the office prescribes.

I request that the card be issued at the earliest.

Yours faithfully,

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