Vku{o Lkt-60

(rLkÞ{ 144 çkeLke ºkeS òuøkðkE {wsçk)

su ÔÞÂõík Ãkh{uLkLx yufkWLx Lktçkh fu sLkh÷ ELzuûk hSMxh Lktçkh Ähkðíke LkÚke yLku íkuyku rLkÞ{ 114
çkeLke f÷{ (yu) Úke (yu[) nuX¤Lkk nkuEÃký ÔÞðnkh {kxu hkufzuÚke [wfðýe fhu íkku íku{ýu yk zuf÷uhuþLk
Vku{o VkE÷ fhðwt
1. ònuh fhLkkhLkwt MktÃkqýo Lkk{ yLku MkhLkk{wt :- ............................................,
hnuðkMke : ...............................................................
2. ÔÞðnkhLke rðøkík :-
3. ÔÞðnkhLke hf{ :-
4. fh {kxu ykÃk ykfkhýe ÃkkBÞk Aku ? nk/Lkk
5. òu nk íkku...
(yu) AuÕ÷w ykðf rhxLko sÞkt VkE÷ fhkÔÞwt nkuÞ íku ðkuzo/Mkfo÷/huLsLke rðøkík.
.................................................................................
(çke) Ãkh{uLkLx yufkWLx Lktçkh/sLkh÷ ELzuûk Lktçkh ÄhkððkLkkt fkhýku.
.................................................................................
6. fku÷{ (1) {kt Ëþkoðu÷ MkhLkk{kLkk ykÄkhYÃk ÃkwhkðkLke rðøkík.
[kufMkkE :-
nwt............................................... ykÚke ònuh fY Awt fu WÃkh su rðøkíkku Ëþkoðe Au
íku {khk òýðk yLku {kLkðk {wsçk MktÃkqýo Mkk[e Au.
yksu............ðkh yLku /01/2013 Lkk hkus [kufMkkE fhe.
íkkhe¾ :- ..../01/2013
MÚk¤ :- y{ËkðkË
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ònuh fhLkkhLke Mkne
Mkw[Lkkyku :- MkhLkk{k{kt ÃkwhkðkYÃk hsw fhe þfkÞ íkuðk ËMíkkðuòu.
(yu) huþLkfkzo.
(çke) ÃkkMkÃkkuxo.
(Mke) zÙkE®ðøk ÷kÞMkLMk.
(ze) fkuEÃký MktMÚkk îkhk yÃkkÞu÷ yku¤¾Ãkºk.
(E) hnuýktfLkwt MkhLkk{wt Äkhkðíkwt ðesrçk÷ yÚkðk xur÷VkuLk rçk÷ Lkf÷.
(yuV) fuLÿ Mkhfkh, hksÞ Mkhfkh fu MÚkkrLkf MktMÚkkLkk yrÄfkhe ÿkhk hnuýktfLkwt MkhLkk{wt
Ëþkoðíkku fkuEÃký ËMíkkðus fu ÃkºkÔÞðnkh.
(S) zuf÷uhuþLk{kt Ëþkoðu÷ MkhLkk{kt {kxuLkku yLÞ fkuEÃký ykÄkh YÃk Ãkwhkðku.
(yu[) {íkËkLk yku¤¾fkzo