ਸੀਨੀਅਰ ਸਿਟੀਜ਼ਨ ਕਾਰਡ ਅਰਜ਼ੀ

APPLICATION FOR A SENIOR CITIZEN CARD

To
The Officer-in-charge,
the office named on the portal or at the counter.

Subject: Application for issue of a Senior Citizen Card

Sir/Madam,

I, Harbhajan Singh, son of Sh. Mohinder Singh, born on 1 April 2026 and aged 67 years, resident of House No. 54, Model Town, Patiala, Punjab 147001, Aadhaar No. XXXX XXXX 1234, mobile 98765 43210, request that a Senior Citizen Card be issued to me.

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.

(b) I ordinarily reside at the address stated above, within the State of Punjab, and have lived there since 2 April 2026.

(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,

Signature: ______________________________
Harbhajan Singh
Place: Patiala
Date: 3 April 2026