(1)

Ļ¯ೇಷ ªಾಜÍ ಪĦΐೆ

ಕකბಟಕ ಸ౽ბರ

๸ಒ౲: ౽ಇ 386 ಎฯ ಇഔ 2023 ಕකბಟಕ ಸ౽ბರದ ಸ೉฿ಲಯ,

เ౽ಸ๷ಧ,

റII ෈.ಆฑ. ಅಂ෎ಡౙฑ เೕൽ,

෍ಂಗิฆ, ൽකಂಕ:03/11/2025.

ಅඌ๰ಚච

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ (ಃ౹ೕ෥෗ไൽ౫) ಅඌඛಯಮ, 2024

(2024ರ ಕකბಟಕ ಅඌඛಯಮ 46) ರ 21ඡ ಪ౳ಕರಣದ ෩ಲಕ ಪ౳ದತ౨฿ದ ಅඌ౽ರಗಳඝ౬

ಚม෵๭, ಕකბಟಕ ಸ౽ბರโ ರ೉ಸฤ ಪ౳๬౨ඪ๭ฆವ ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರ ๬෥೧ಕ ಭದ౳൤ ಮൡ౨ ಃ౹ೕ෥෗ไൽ౫ ඛಯಮಗำ, 2025ರ ಕರಡඝ౬ ಸದค

ಪ౳ಕರಣದ (1)ඡ ಉಪ ಪ౳ಕರಣದ ෩ಲಕ ಅಗತ౲ ಪലಸมඈ൤, ൽකಂಕ: 24/09/2025 ರ

ಕකბಟಕ ฃಜ౲ಪತ౳ದ ූಗ IVA ๸ಒ౲:627 ರย౵ನ ಅඌ๰ಚච ๸ಒ౲: LD 386 LET 2023,

ൽකಂಕ: 24/09/2025 ರย౵ ಪ౳ಕഔ๭ൿ౪, ಇವฆ ಅඌಂತ ฃಜ౲ಪತ౳ದย౵ ಪ౳ಕಟ฿ದ

ൽකಂಕൽಂದ 30 ൽನಗಳ ಒಳಛಜ ಅದคಂದ ෇ඌತ฿ಞವ ๸ಭವเฆವ ಎม౵

ವ౲౾౨ಗัಂದ ಆಃ౹ೕಪൕಗำ ಅಥ฿ ಸಲກಗಳඝ౬ ಆ๻౷ඛ๭ฆโದคಂದ,

ಮൡ౨

ಸದค

ฃಜ౲ಪತ౳ವඝ౬

ൽකಂಕ:

24/09/2025

ฏൿ

๬ವბಜඛಕคಡ

ಲಭ౲฿ಞ๋൤ ෥ಡมಜฆโದคಂದ,

ಮൡ౨ ಈ

ಬಡ౛

๭౷ೕಂತತಂಡ

ಆಃ౹ೕಪൕಗಳඝ౬

ฃಜ౲

ಸ౽ბರโ

ಪคಗ൐๭ฆโದคಂದ,

ಆൿದคಂದ, ಈಗ, ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ (ಃ౹ೕ෥෗ไൽ౫)

ಅඌඛಯಮ, 2024 (2024ರ ಕකბಟಕ ಅඌඛಯಮ 46) ರ 21ඡ ಪ౳ಕರಣದ ෩ಲಕ

ಪ౳ದತ౨฿ದ ಅඌ౽ರಗಳඝ౬ ಚม෵๭, ಕකბಟಕ ಸ౽ბರโ ಈ ෩ಲಕ ಈ ෨ಂൽನ

ඛಯಮಗಳඝ౬ ರ೉๯ತ౨ං. ಎಂದฉ:-

¨sÁUÀ – 4ಎ

Part – IVA

05

, 2025 (

, 14,

, ೧೯೪7)

BENGALURU, WEDNESDAY 05, NOVEMBER, 2025 ( KARTHIKA , 14, SHAKAVARSHA, 1947)

. 693

No. 693

2

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ๬෥೧ಕ ಭದ౳൤ ಮൡ౨

ಃ౹ೕ෥෗ไൽ౫ ඛಯಮಗำ, 2025

1. ๸౾౹ಪ౨ ກಸฆ, ඩ౳ฏಭ ಮൡ౨ ಅನ౷ಯ:- (1) ಈ ඛಯಮಗಳඝ౬ ಕකბಟಕ ๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ ౽ಯბಕತბರ (ಃ౹ೕ෥෗ไൽ౫) ඛಯಮಗำ, 2025 ಎಂൿ ಕฉಯತಕౙൿ౪.

(2) ಈ ඛಯಮಗำ ಸ౽ბค ฃಜ౲ಪತ౳ದย౵ ಅโಗಳඝ౬ ಅಂൟಮ฿ಜ ಪ౳ಕഔ๭ದ

ൽකಂಕൽಂದ ೦คಡ ಬರತಕౙൿ౪.

(3) ಈ ඛಯಮಗำ ಅඌඛಯಮದ 2ඡ ಪ౳ಕರಣದ (ಒ) ಘಡದย౵ ಪคූ๞ಸมඈ൤

ಪ౳ൟ෽ಂൿ ಉದ౲ಮಁౙ ಅನ౷ಯ฿ಗತಕౙൿ౪.

2. ಪคූ๣ಗำ:-(1) ಈ ඛಯಮಗಳย౵ ๸ದಭბโ ಅನ౲൞ ಅಗತ౲ಪല๭ದ ຄರൡ,-

(ಎ) “ಅඌඛಯಮ” ಎಂದฉ, ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ

(ಃ౹ೕ෥෗ไൽ౫) ಅඌඛಯಮ, 2024 (2024ರ ಕකბಟಕ ಅඌඛಯಮ 46);

(෈) “ಅಪಪತ” ಎಂದฉ, ಅಪฃಧ ಉං౫ೕಶ ಮൡ౨ ಅඛคೕ౾౹ತ ಂತ౲เಲ౵ං ಇದ౪౾ದ౪ಂ൤

๸ಭเ๯ವ ಒಂൿ ಘಟච෴ಜൿ౪, ಇದคಂർಜ ๬โ ಅಥ฿ ಅಸಮಥბ൤ಡ

౽ರಣ฿ಞವ ๎ಶ౷ತ ಅಥ฿ ๸තಣბ ಅಥ฿ ූಗ๛ ಅಂಗ็ಕಲ౲൤;

(๭) "ಉඅ౲ೕಗർತ" ಎಂದฉ ಪ౳ತ౲ౘ฿ಜ ಅಥ฿ ಪฌೕౘ฿ಜ ๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ ౽ಯბಕತბರඝ౬ ඡಮಕ ෥ലಆำ౶ವ ವ౲౾౨;

(ല) "ಅಧ౲ౘฆ" ಎಂದฉ ෱ಡัಯ ಅಧ౲ౘฆ;

(ಇ) "ಸದಸ౲" ಎಂದฉ ෱ಡัಯ ಸದಸ౲; ಮൡ౨

(ಎෆ) "ಪ౳ಕರಣ" ಎಂದฉ ಅඌඛಯಮದ ಪ౳ಕರಣ.

(2) ಈ ಅඌඛಯಮದย౵ ಬಳಸมದ ಆದฉ ಪคූ๞๭ಲ౵ದ ಎม౵ ಇತರ ಪದಗำ ಮൡ౨

ಪർವัಗำ

ಅඌඛಯಮದย౵

ಅโಗัಡ

ඛೕಡมದ

ಅಥბಗಳච౬ೕ

ຄಂൽರತಕౙൿ౪.

3. ಸದಸ౲ರ ಭ൤౲:- (1) ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯ ಅඌಂತ ಸದಸ౲ರ ಪ౳෴ಣ ಭ൤౲ಯඝ౬ ಆತඝ ಅඌಂತ ಕತბವ౲ಗಳย౵

ඛವბ๼๯ವ

ಪ౳෴ಣಃౙ

๸ීඌ๭ඈ൤

ಅನ౷ಯ฿ಞವ

ඛಯಮಗಳ

෩ಲಕ

ඛವბ๼ಸತಕౙൿ౪ ಮൡ౨ ಆತನ ๆತನವඝ౬ ඩವൟ๯ವ ඩ౳ඌ౽ರದโ ๸ർಯ

෥ಡತಕౙൿ౪.

(2) ෱ಡัಯ ಅඌ౽ชತರ ಸದಸ౲ฆ ಪ౳෴ಣ ಭ൤౲

ඩವൟ (ಸ෦ൟಗำ,

ಆ෽ೕಗಗำ ಅಥ฿ ಇತರ ๸๲౩ಗಳ ಅඌ౽ชತರ ಸದಸ౲ฆ) ඛಯಮಗำ, 2001ರ

ಉಪීಧಗำ ಮൡ౨ ಕකბಟಕ කಗคಕ ๳฿ ඛಯಮಗಳ ಅඝීಧ-ಎ

ಅඝ๬ರ

ಪ౳෴ಣ

ಭ൤౲

ಮൡ౨

඄ඦൽನ

ಭ൤౲ಯ

ඩವൟಡ

ಹಀౙಳ౶ವฃಜರತಕౙൿ౪.

4. ಸො:- (1) ෱ಡั෷ ಅಧ౲ౘฆ ඛಧბคಸಬ๾ർඈಥ ಸ౩ಳಗಳย౵ ಮൡ౨ ౽ಲಗಳย౵

ಸො ๳ರತಕౙൿ౪ ಆದฉ ෩ฆ ൟಂಗಳย౵ ಕඛಷ౤ ಒಂൿ ෇ค෴ದง ಸො ๳ರತಕౙൿ౪.

(2) ๬෥ನ౲฿ಜ, ෱ಡัಯ ಸದಸ౲คಡ ಪ౳๬౨เತ ಸොಯ ಎರഴ ฿ರಗಳ ෨ಂ೎

ඣೕഔ๺ ಅඝ౬ ඛೕಡತಕౙൿ౪.

3

ಪฏൡ, ಅಧ౲ౘฆ, ๻ಡ ෥ഴโൿ ಅಗತ౲ๅಂൿ ಮನಧಡฉ, ಅಂತಹ ಸොಡ

๸ීඌ๭ඈ൤ ಒಂൿ ൟಂಗำ ෦ೕರದ ๻ಡ ൽೕಪბವඌಯ ඣೕഔಸඝ౬ ಸಹ

ඛೕಡಬ๾ൿ.

(3) ෱ಡัಯ ಸොಡ ๸ීඌ๭ದ ౽ಯბಕมಪದ ಪഔౣಯย౵ ๳คಸมಜದ౪

ຄರൡ ಅಧ౲ౘರ ಅඝಮൟ෵ಲ౵ං ಸොಯย౵ ෴โඃ ౽ಯბಕมಪವඝ౬

ಪคಗ൐ಸತಕౙದ౪ಲ౵.

(4) ಅಧ౲ౘฆ ಚ೎ბಯ เಷಯ ಮൡ౨ ൡൡბ ౽ರಣದ ಬಡ౛ ಸದಸ౲คಡ ෨ಂ೉ತ฿ಜ

ൟั๭ದ ತฆ฿ಯ, ൡൡბ ๸ದಭბದย౵ ෴โඃ ಸಮಯದย౵ ෱ಡัಯ

เ๕ಷ ಸොಯඝ౬ ಕฉಯಬ๾ൿ.

5. ಆೕฏ:-(1) ෱ಡัಯ ෴โඃ ಸොಯย౵ ๕ಕറ ಐವತ౨ರ๠ౣ ಸದಸ౲ฆ ๻ಜคದ౪

ຄರൡ ෴โඃ ౽ಯბಕมಪ ನഷಸತಕౙದ౪ಲ౵:

ಪฏൡ, ಸොಯย౵, ๕ಕറ ಐವತ౨౾ౙಂತล ಕല෫ ಸದಸ౲ฆ ๻ಜคದ౪ฉ, ಅಧ౲ౘฆ

ಸොಯඝ౬ ಇඣ౬ಂൿ ൽකಂಕಃౙ ෨ಂ඀ല, ๻ಜคದ౪ ಸದಸ౲คಡ ൟัಸತಕౙൿ౪ ಮൡ౨

ಸොಡ ๻ಜฃಗದ ಸದಸ౲คಡ ൞ඝ ෨ಂ඀ಡมದ ಸොಯย౵ ඛೕโ ๻ಜคರย ಅಥ฿

ಇಲ౵ൽರย ౽ಯბಕมಪವඝ౬ ನഷಸฤ ಉං౪ೕ๏๭ං౪ೕච ಎಂൿ ඣೕഔಸඝ౬ ඛೕല, ಆ

ತฆ฿ಯ ಅವฆ ๻ಜคฆವ ಸದಸ౲ರ ๸ಒ౲ಯඝ౬ ว౾ౙಸං ෨ಂ඀ಡಲ౭ಟౣ ಸොಯย౵

౽ಯბಕมಪವඝ౬ ನഷಸಬ๾ൿ.

(2) ฃಜ౲ ಸ౽ბರโ, ಪದඛ෦ತ౨ ಸದಸ౲ರඝ౬ ຄರൡಪല๭, ෴โඃ ಸದಸ౲ඝ

෱ಡัಯ ಸොಯย౵ ූಗವ๼๯โದඝ౬ ඛ๤ඌಸಬ๾ൿ, ಒಂൿ ๆึ:-

(ಎ) ಸದಸ౲ฆ ಅಧ౲ౘคಡ ย಍ತ ෥๼ൟ ඛೕಡං ಮൡ౨ ಅವคಂದ ಒඪ౭ಡ ಪഷಯං

෱ಡัಯ ಸತತ ෩ฆ ಸොಗัಡ ಣฆ ๻ಜฃಜದ౪ฉ; ಅಥ฿

(෈)

ฃಜ౲

ಸ౽ბರದ

ಅ෗ඩ౳ಯದย౵

ಸದಸ౲ฆ

෱ಡัಯย౵

൞โ

ಪ౳ൟඛඌ๯ವฉಂൿ

൞ತ౭ಯბ฿ಞವ

๼൞ಸ౾౨ಯඝ౬

ಪ౳ൟඛඌ๯โದඝ౬

ඛย౵๭ದ౪ฉ.

6. ඣೕಂದ൐ ಅඌ౽คಗಳ ඡಮ౽ൟ:-

(ಎ)

ಸ౽ბರโ, ౽෦ბಕ

ಇมಒಯย౵ನ

౽෦ბಕ

ඛคೕౘಕರ

ದ೬ბಜಂತ

ಕല෫෵ರದ ಸ౽ბರದ ಅඌ౽คಗะಜฆವ ൞ඝ ๰ಕ౨ๅಂൿ ූเ๯๋ಥ

ವ౲౾౨ಗಳඝ౬, ಈ ಅඌඛಯಮದ ಉං౪ೕಶಗัಛಜ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರඝ౬ ඣೕಂർ෵๭ಆำ౶ವ ඣೕಂದ൐ ಅඌ౽คಗะಜರತಕౙൿ౪;

(෈) ඣೕಂದ൐ ಅඌ౽ค෷ ಈ ಅඌඛಯಮದ ෩ಲಕ ಅಥ฿ ಈ ඛಯಮಗಳ

ಅലಯย౵

ತನಡ

ಪ౳ದತ౨฿ದ

ಅඌ౽ರಗಳඝ౬

෴ವ

෦ൟ෽ಳಡ

ಚม෵ಸ෎ಀ ಎಂ්ದඝ౬ ಪคූ๞ಸತಕౙൿ౪;

(๭) ല೧ಟฯ ඲ೕಟბฯ ಗัಂದ ല೧ಟฯ ದ൞౨ಂಶವඝ౬ ಆ౳ೕലಕค๯โದರ ೯൤ಡ

ඣೕಂದ൐ ಪ౳౾౳෺ಯඝ౬ ಅತಳ౶ฤ ಒಂൿ ല೧ಟฯ ඲ೕಟბฯ ಇರತಕౙൿ౪.

-ಎಂ්ದඝ౬ ಆඃಶದ ෩ಲಕ ಸ౽ბค ฃಜಪತ౳ದย౵ ಅඌ๰೉ಸಬ๾ൿ.

4

7. ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ඣೕಂದ൐- (1) 18 คಂದ 60 ವಷბඅಳಜನ

๻ಟ ಅඌඛಯಮದ 2ඡ ಪ౳ಕರಣದ (ಇ) ಘಡದย౵ ನ෩ൽಸมದ ಪ౳ವಗბಗัಡ

๳คฆವ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ತಮ౱ เะಸದ ඬฃๅ, ಆඋฑ

೯ೕಡൕ෴ಜฆವ ෇౲ಂಋ ඩ๺ ්ಋ ಅಥ฿ ಇ-ಶ౳ෳ (෷ಎಎඨ), ಉඅ౲ೕಗ

ಞฆൟನ ೉ೕഔ (ಲಭ౲เದ౪ฉ) ಅಥ฿ ಉඅ౲ೕಗർತฆ ನ෩ච-II ರย౵ ඛೕലฆವ

ಉඅ౲ೕಗ

ಪ౳෥ಣ

ಪತ౳අಂൽಡ

6ඡ

ඛಯಮದ

(ಎ)

ಘಡದ

ಅലಯย౵

ಅඌ๰೉ಸมದ ඣೕಂದ൐ ಅඌ౽คಗัಡ ನ෩ච-I ರย౵ ಅ೧ბ ಸย౵ಸತಕౙൿ౪.

ಪฏൡ, ಅ೧ბ ಸย౵๯ವ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ ౽ಯბಚഖವഔಃಗಳඝ౬ ඛವბ๼ಸತಕౙൿ౪.

(2) ಅ೧ბർರඝ ಅඌඛಯಮದ 2ඡ ಪ౳ಕರಣದ (ಇ) ಮൡ౨ (ಎෆ) ಘಡಗಳ

ಉಪීಧಗಳඝ౬

ඩย๭ർ౪ච

ಎಂ්โದඝ౬

ಮನವคಃ

෥ലಆಂಡ

ತฆ฿ಯ

ඣೕಂದ൐

ඩ౳ඌ౽ರโ

ಅಂತಹ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರඝ౬

෱ಡัಯ

෽ೕಜචಗಳ

ಫมඝಭเಗะಜ

ඣೕಂർ෵ಸತಕౙൿ౪ ಮൡ౨ ಅವคಡ เ๏ಷౣ ಞฆൟನ ೉ೕഔ ಮൡ౨ ಅದಃౙ

๸ීಧಪಟౣ ರ๭ೕൽಗಳඝ౬ ඛೕಡತಕౙൿ౪. ಞฆൟನ ೉ೕഔ෷ ෩ฆ ವಷბಗಳ

ಅವඌಡ ෥ನ౲฿ಜฆತ౨ං.

(3) ಪ౳ൟ ෩ฆ ವಷბಗัತ෫౱ ඣೕಂದ൐ಯඝ౬ ನเೕಕคಸತಕౙൿ౪. ๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ ౽ಯბಕತბฆเವರಗಳ ಬದมವൕ ෴โർದง ಇದ౪ฉ, ಅದಃౙ

๸ීඌ๭ದ ಅභ ഷങി ದ๬౨ๆಜඝ౬ ನ෩ච-III ರย౵ ಸย౵ಸತಕౙൿ౪.

(4)

ඣೕಂದ൐

ඩ౳ඌ౽ರโ

๯ำ౶

ຂัಃ

ಅಥ฿

ಳೕಷൕಯ

ಅಥ฿

๋ಚච෵ಂದ

ಸ൞౲ಂಶವඝ౬

෨೉౞ഴವ

෩ಲಕ

ඣೕಂದ൐ಯඝ౬

෥ല๭ಆಳ౶มಜං෺ಂൿ ಮನಧಡฉ ಆತඝ ಅಂಥ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರ ඣೕಂದ൐ಯඝ౬ ರൿ౪ತั๯ವ ෮ದฤ, ಈ เಷಯದย౵

ತಮ౱ ಪ౳ൟ฿ದವඝ౬ ෱ലಸฤ ෇ඌತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბคಡ

ಅವ౽ಶವඝ౬ ඛೕലದ ತฆ฿ಯ ಆತನ ඣೕಂದ൐ಯඝ౬ ರൿ౪ತัಸತಕౙൿ౪.

(5) ඣೕಂದ൐ ඩ౳ඌ౽ರโ ಪ౳ൟ෽ಬ౯ ಫมඝಭเಟ ನ෩ච-IV ರย౵

ಫมඝಭเಯ ූವ೉ತ౳โಳ౶ เ๏ಷౣ ಞฆൟನ ೉ೕഔಯඝ౬ ඛೕഴತ౨ං.

8. ಉಪಕರ ๸ಗ౳ಹൕ ಮൡ౨ ඛಧბರൕ.-(1) ಮยౣද౵ಋ౺ ೉ತ౳෱ൽರಗำ ๳คඈ൤ ಎม౵

೉ತ౳෱ൽರಗಳ ๭ඛ෥ ഔಃഡ ಗಳ ෬ว ๕ಕറ ಎರಡರ๠ౣ ಉಪಕರ เඌ๯โൿ.

(2) ಕකბಟಕ ฃಜ౲ದย౵ ౽ಯბඛವბ๼๯ൟ౨ฆವ ඀ರದಶბನ ಮನฏಜක

฿๼ඛಗಳ ಒഖౣ ವ๼฿ഔನ ෬ว ๕ಕറ ಎರಡರ๠ౣ ಉಪಕರ เඌ๯โൿ.

(3) ಸ౽ბರโ ౽ಲ౽ಲಃౙ ಅඌ๰೉๭ದ ๸๲౩ಗัಂದ ಉಪಕರವඝ౬ เඌ๯โൿ,

ඛಧბರൕ

෥ഴโൿ

ಮൡ౨

๸ಗ౳๼๯โದඝ౬

ಸ౽ბರโ

ಸ౽ბค

ฃಜಪತ౳ದย౵ ಅඌ๰೉๭ದ ಅಂಥ คೕൟಯย౵ ಅಥ฿ ಅಂಥ ಸಮಯದย౵ ಮൡ౨

ಅಂಥ ಮಧ౲ಂತರಗಳย౵ ෥ಡมಞತ౨ං.

(4)

ಸ౽ბರโ

ಉಪಕರವඝ౬

๸ಗ౳๼๭,

൤౳ೖ෥๭ಕ฿ಜ

෱ಡัಡ

ವಛბ෵ಸತಕౙൿ౪.

5

9. ಸ౽ბರൽಂದ ಸ๻෴ඝඋನಗำ:- ๭ඛ෥ ಮൡ౨ ඀ರದಶბನ ฿๼ඛಗಳ

౽ಯბಕತბರඝ౬

ຄರൡಪല๭

ಇತರ

๬ಂಸౙೃൟಕ

౽ಯბಕತბคಡ

ಸ౽ბค

ಅඝർನಗಳඝ౬ ງ೉ಃ ෥ಡมಞโൿ.

10. ๸ಗ౳ಹ൏ ಅඌ౽คಯ ඡಮ౽ൟ:-

(ಎ)

ಸ౽ბರโ, ౽෦ბಕ

ಇมಒಯย౵

౽෦ბಕ

ಅඌ౽คಗಳ

ದ೬ბಜಂತ

ಕല෫෵ರದ ಸ౽ბರದ ಅඌ౽คಗะಜฆವ ಅൿ ๰ಕ౨ๅಂൿ ූเ๯๋ಥ

ವ౲౾౨ಗಳඝ౬ ಅඌඛಯಮ ಮൡ౨ ಈ ඛಯಮಗಳ ಉං౪ೕಶಗัಛಜ ಉಪಕರವඝ౬

๸ಗ౳๼ಸฤ ๸ಗ౳ಹ൏ ಅඌ౽คಗಳක౬ಜ ඡಮಕ ෥ലಆำ౶โൿ;

(෈) ๸ಗ౳ಹ൏ ಅඌ౽ค෷ ಅඌඛಯಮ ಮൡ౨ ಈ ඛಯಮಗಳ ෩ಲಕ ಅಥ฿

ಅದರ ಅലಯย౵ ಆತඛಡ ಪ౳ದತ౨฿ದ ಅඌ౽ರಗಳඝ౬ ෴ವ ෦ൟ෽ಳಡ

ಚม෵ಸ෎ಀ ಎಂ්ದඝ౬ ඛඌბಷౣಪല๯โൿ;

(๭) ല೧ಟฯ ඲ೕಟბฯ ಗัಂದ ല೧ಟฯ ದ൞౨ಂಶವඝ౬ ಆ౳ೕലಕค๯โದರ ೯൤ಡ

๸ಗ౳ಹ൏ ಪ౳౾౳෺ಯඝ౬ ಅತಳ౶ฤ ಒಂൿ ല೧ಟฯ ඲ೕಟბฯ ಇರತಕౙൿ౪.

-ಎಂ්ದඝ౬ ಆඃಶದ ෩ಲಕ ಅඌಂತ ฃಜಪತ౳ದย౵ ಅඌ๰೉ಸಬ๾ൿ.

11. ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರ:- ಸ౽ბರโ, ಕකბಟಕ ฃಜ౲ಪತ౳ದย౵ ಅඌ๰ಚචಯ ෩ಲಕ,

౽෦ბಕ ಇมಒಯย౵ ౽෦ბಕ ಅඌ౽คಗಳ ದ೬ბಜಂತ ಕല෫෵ರದ ಅൿ

๰ಕ౨ๅಂൿ ූเ๯๋ಥ ฃಜ౲ ಸ౽ბರದ ಅඌ౽คಗಳඝ౬ ಃ౵ೕ෨ ඩ౳ඌ౽ರ฿ಜ

ඡಮಕ ෥ಡಬ๾ൿ.

12. ಮರಣ, ಅಂಗ็ಕಲ౲ ಮൡ౨ ็ದ౲౾ೕಯ ๅಚ౞ದ ಮฆඩವൟಯ ๸ದಭბದย౵

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბคಡ ಅಪಪತದ ಪค๻ರ:-

(1) ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ಮರಣ, ಅಂಗ็ಕಲ౲ ಮൡ౨

็ದ౲౾ೕಯ ๅಚ౞ದ ಮฆඩವൟಯ ๸ದಭბದย౵ ಅಪಪತದ ಪค๻ರ౽ౙಜ

ಅಹბฃಜರತಕౙൿ౪.

ಪฏൡ, ಕತბವ౲ದย౵ർ౪ಗ ๸ಭเ๭ದ ຀ದಯ ಸ౨ಂಭನದ ๬เನ (຀ದಯಪತ)

๸ದಭბದย౵ ಸಹ ಅඃ ಪ౳෽ೕಜನโ ಲಭ౲เರತಕౙൿ౪.

(2) ಪ౳ൟ෽ಬ౯ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბඝ, ಆತನ

ಉඅ౲ೕಗದ

ಅವඌಯย౵

ಅಥ฿

ಆತನ/

ಆಃಯ

ಉඅ౲ೕಗ

ຄರಜನ

ಅವඌಯย౵

ಅಪಪತಃౙ

ಒಳಛದฉ

ಆತඝ

ಈ

ඛಯಮಗಳ

ಅലಯย౵

෱ಡั෷

ඛೕഴವ

ಎม౵

ಅಪಪತ

ಪ౳෽ೕಜನಗಳඝ౬

ಪഷಯฤ

ಅಹბකಜರತಕౙൿ౪:

ಪฏൡ, ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ಈ ಃಳಉಡ

๸ದಭბಗಳย౵

ಈ

ඛಯಮಗಳ

ಅലಯย౵

ಅಪಪತ

ಪ౳෽ೕಜನಗัಡ

ಅಹბฃಜರತಕౙದ౪ಲ౵,-

(a) ๬౷ූเಕ ಮರಣ.

(b) ಈ

ಃಳಉಡโಗಳ

ಪค൏ಮ฿ಜ

ಉಂഓದ

ಮರಣ

ಅಥ฿

ಛಯಃౙ

๸ීඌ๭ඈ൤ ಪค๻ರದ ඩವൟ:-

6

(c) ಆತ౱ಹ൤౲

෥ലಆำ౶โൿ

ಅಥ฿

෥ലಆಳ౶ฤ

ಪ౳ಯൟ౬๯โൿ,

ಉං౪ೕಶතವბಕ฿ಜ ಸ౷൫ ಛಯ ෥ലಆำ౶โൿ;

(d) ಮದ౲ ಅಥ฿ ෥ದಕ ದ౳ವ౲ಗಳ ಪ౳ූವಆౙಳಛಞโൿ;

(e) ಅಪฃඌಕ ಉං౪ೕಶൽಂದ ෴โඃ ౽ඞඝ ಉಲ౵ಂಘච ෥ഴโൿ.

(3) ಃ౵ೕ෨ಗಳ ౽ಯბเඋನโ ಈ ಃಳಉഽൟರತಕౙൿ౪, ಎಂದฉ:-

(ಎ) ಪ౳ൟ෽ಬ౯ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ಅಥ฿ (2) ඡ

ಉಪ-ඛಯಮದ ಅലಯย౵ ಅಪಪತ ಪ౳෽ೕಜನಃౙ ಅಹბฃಜฆ๋ಥಆತನ

෮ದಲ ೧ೕ๋ತ කಮඛඃბ๏ತฆ, ಮರಣಃౙ ๸ීඌ๭ඈ൤ ඛಯಮ 13ರ

ಅലಯย౵

ಅඌ๰೉ತ

ಃ౵ೕ෨ಗಳ

ඩ౳ඌ౽ರಃౙ

ನ෩ච-Vರย౵

ಅ೧ბ

ಸย౵ಸತಕౙൿ౪ ๻ಟ ಅಪಪತ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲൤ ಅಥ฿ ็ದ౲౾ೕಯ

ಮฆඩವൟಛಜ ಎෆಐಆฑ , ಮರ൘ೕತ౨ರ ಪคೕಃ౹ಯ ವರൽ, ෪ತರ ೧ೕ๋ತ

ಸದಸ౲ ಪ౳෥ಣಪತ౳ ಮൡ౨ ಮರಣ ಪ౳෥ಣಪತ౳ (ಮರಣದ ๸ದಭბದย౵), ෩ಲ

็ದ౲౾ೕಯ

෈ฯ౵ ಗำ

ಮൡ౨

็ದ౲౾ೕಯ

ಮฆඩವൟಡ

๸ීඌ๭ದ

ല๬ౣ೴ ბ ๬ฃಂಶ

ಮൡ౨

ಅಪಪತದ

౽ರಣൽಂർಜ

ಅ೧ბർರฆ

ಅඝಭเ๭ದ ๎ಶ౷ತ ಒഖౣ ಅಂಗ็ಕಲ౲ (ಅ๬ಮಥ౲ბ) ಅಥ฿ ๎ಶ౷ತ ූಗ๛

ಅಂಗ็ಕಲ౲ದ ๕ಕറ฿ฆ ಪ౳෥ಣವඝ౬ ಸ౭ಷౣ฿ಜ ൧ೕค๯ವ ൞ลಀ

ಅಥ฿

೧ม౵

็ದ౲౾ೕಯ

෱ಡั෷

ඛೕലದ

็ದ౲౾ೕಯ

ಪ౳෥ಣಪತ౳අಂൽಡ ನ෩ච- VI ರย౵ ಅ೧ბ ಸย౵ಸತಕౙൿ౪.

(෈)ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರโ ಅಪಪತದ ಪ౳෽ೕಜನಃౙ ๸ීಧಪಟౣ ಪ౳ൟ෽ಂൿ

ಅ೧ბಯඝ౬

ಅඌඛಯಮದ

ಉಪීಧಗำ

ಮൡ౨

ಈ

ඛಯಮಗัಡ

ಅඝಞಣ฿ಜ ಪค๏ೕยಸತಕౙൿ౪ ๻ಟ ಃ౵ೕಮඝ౬ ๭౷ೕಕคಸಬ๾ൿ ಅಥ฿

ൟರಸౙคಸಬ๾ൿ.

ಪฏൡ, ಈ ಪರ฿ಜ ಃ౵ೕ෨ ඩ౳ඌ౽ರโ, ಅಪಪತ ಪ౳෽ೕಜನಃౙ ๸ීඌ๭ದ ಃ౵ೕಮඝ౬

ൟರಸౙค๯ವ ෮ದฤ, ಅ೧ბർರคಡ ಮನเಯඝ౬ ಸย౵ಸฤ ๰ಕ౨ ಅವ౽ಶವඝ౬

ඛೕಡತಕౙൿ౪.

(๭) ಮರಣ, ๎ಶ౷ತ ๸තಣბ ಅಂಗ็ಕಲ౲ ಮൡ౨ ๎ಶ౷ತ ූಗ๛ ಅಂಗ็ಕಲ౲ದ

๸ದಭბದย౵ ಪค๻ರದ ෮ತ౨โ ಅಂಗ็ಕಲ౲ದ ๕ಕಡ฿ฆ ಅඝඩತದย౵

ಅಥ฿

ಆಸ౭൤౳ಯ

ๅಚ౞ದ

ಮฆඩವൟಡ

ಅඝಞಣ฿ಜ

ಸ౽ბರโ

ಅඌ๰ಚචಯ ෩ಲಕ ඛൽბಷౣಪല๭ඈ൤ ಇರತಕౙൿ౪.

13. ๬౷ූเಕ ಮರಣದ චರโ (ಅಂತ౲౾౳෺ ๅಚ౞ಗำ ಒಳತಂഽ൤):-

(1) ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ๬౷ූเಕ฿ಜ ඛಧನฃದฉ,

ಃ౵ೕ෨ಗಳ

ඩ౳ඌ౽ರโ,

ಸ౽ბರโ౽ಲ౽ಲಃౙ

ಅඌ๰ಚචಯ

෩ಲಕ

ಅඌ๰೉๭ඈ൤ ෪ತ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ

කಮඛඃბ๏ತคಡ ෪ತ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ

ಅಂತ౲౾౳෺ ๅಚ౞ಗิ ಒಳತಂഽ൤ ಅಂಥ ෮ತ౨ವඝ౬ ඩವൟಸತಕౙൿ౪.

(2) ಉಪ-ඛಯಮ (1)ರย౵ ඛൽბಷౣಪല๭ದ ෮ತ౨ದ ಃ౵ೕ෦ಛಜನ ಅ೧ბ෷ ನ෩ච-VII

ನย౵ರತಕౙൿ౪ ಮൡ౨ ಈ ಅ೧ბ෷ ෪ತ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

7

౽ಯბಕತბರ ಮರಣ ಪ౳෥ಣಪತ౳, ಉർಯ ಇมಒ෷ ඛೕലฆವ ೧ೕ๋ತ

ಸದಸ౲ ಪ౳෥ಣಪತ౳, ಆඋฑ ೯ೕಡൕ෴ದ ෇౲ಂಋ ඩ๺ ්ಋ ಮൡ౨ ෪ತ ๭ඛ

ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბคಡ ඛೕಡมದ ෩ಲ ಞฆൟನ ೉ೕഔ ಅಥ฿

෩ಲ ಞฆൟನ ೉ೕഔ෷ ಲಭ౲เಲ౵ದ ๸ದಭბದย౵ ෱ಡั෷ ๭ಂඎತ౷ ಮൡ౨

ඛಖರ൤ಯ

ಪค๏ೕಲචಛಜ

ಫมඝಭเಯ

ඣೕಂದ൐

๸ಒ౲෵ಂದ

ಲಗ൞౨ಜರತಕౙൿ౪.

14. ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ චರโ:- (1)

ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರโ, ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ

ನ෩ච-VIIIರย౵ ಸย౵๭ದ ಅ೧ბಗಳ ෬ว, ಪ౳ൟ ವಷბ ಅವರ ಅವอ෈ತ ಮಕౙัಡ

ಎರഴ ಮಕౙำ ෦ೕರඈ൤, ಈ ಃಳಉಡ ಆೕಷౣಕದย౵ ඛൽბಷౣಪല๭ದ ಆೕ๺ ბಗัಡ

฿๞ბಕ ๖ౘ൐ಕ චರವඝ౬ ෱೪ฆ ෥ಡಬ๾ൿ.

ಆೕಷౣಕ

ಕ౳ಮ

๸ಒ౲

๖ౘ൐ಕ ಆೕ๺ ბಗำ

01

12ඡ ಅಥ฿ ತತ౺෥ನ

02

ಪದเ ಅಥ฿ ತತ౺෥ನ

03

ಎฯ ಎฯ ෈/ ඩ౲ฃ ෫ലಕฯ / ෈.මෳ ბ/ ನ๭ბಂ಩ ๻ಟ ฃಜ౲ ಸ౽ბರโ

ඛൽბಷౣಪല๭ඈ൤ ಇತರ ไൟ౨ಯ ಆೕ๺ ბಗำ

04

ಎෳ ෈෈ಎ๺ /෈ಇ/෈.ങಋ ಮൡ౨ ๬౬ತಆೕತ౨ರ ಪದเ ಆೕ๺ ბಗำ

(2) ಃ౵ೕ෨ ඩ౳ඌ౽ರโ ಸ౽ბರโ ಅඌ๰ಚචಯ ෩ಲಕ ಅඌ๰೉๭ದ ಅಂಥ

෮ತ౨ವඝ౬ ඩವൟಸತಕౙൿ౪.

(3) ಪ౳๯౨ತ ಪ౳ๆಶ ಪഷದ ಮൡ౨ ಸ౽ბರൽಂದ ෥ನ౲൤ ಪഷದ ๸๲౩ಗಳย౵ ඛಯತ

ಆೕ๺ ბಗัಡ ಪ౳ๆಶ ಪഷದ เർ౲൮ბಗัಡ ෥ತ౳ ๖ౘ൐ಕ චರโඅฉಯತಕౙൿ౪:

ಪฏൡ, ಈ ๖ౘ൐ಕ චರโ ඀ರ ๏ౘಣ ಆೕ๺ ბಗำ, ಠಹ ಅಧ౲ಯನ ಆೕ๺ ბಗำ

ಆච౵ೖඨ ಆೕ๺ ბಗำ ෨ಂ൞ದโಗัಛಜ අฉಯತಕౙದ౪ಲ౵.

15. ಅಪಪತ ౽ರಣൽಂർಜ ෪ತ/ ๸තಣბ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲ ຄಂൽದ

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ චರโ:- (1)

ಃ౵ೕ෨ ඩ౳ඌ౽ರโ, ಅಪಪತൽಂർಜ ಮರಣ ຄಂൽದಅಥ฿ ๎ಶ౷ತ ๸තಣბ

ಅಂಗเಕಲ൤ಡ ಒಳಛದ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಅವอ෈ತ ಮಕౙัಡ

(ಇಬ౯ฆ ಮಕౙำ ෦ೕರඈ൤) ಆೕಷౣಕದย౵ ඛൽბಷౣಪല๭ದ ಆೕ๺ ბಗัಛಜ ಪ౳ൟ

ವಷბ ฿๞ბಕ ๖ౘ൐ಕ චರವඝ౬ ෱೪ฆ ෥ಡಬ๾ൿ.

8

ಆೕಷౣಕ

ಕ౳ಮ

๸ಒ౲

๖ౘ൐ಕ ಆೕ๺ ბಗಳ ກಸฆ

01

1ඡ ತರಗൟ෵ಂದ ಪದเ ಮൡ౨ ತತ౺෥ನ ಪದเ ವฉಡ

02

ಎฯ ಎฯ ෈/ඩ౲ฃ ෫ലಕฯ /෈.මෳ ბ/ನ๭ბಂ಩ ๻ಟ ಇತರ ไൟ౨ಯ

ಆೕ๺ ბಗำ ಇ൞౲ൽ.

03

ಎෳ ෈෈ಎ๺ /෈ಇ/෈.ങಋ ಮൡ౨ ๬౬ತಆೕತ౨ರ ಪದเ ಆೕ๺ ბಗำ

(2) ಃ౵ೕ෨ ඩ౳ඌ౽ರโ ಸ౽ბರโ ౽ಲ౽ಲಃౙ ಅඌ๰ಚචಯ ෩ಲಕ ಅඌ๰೉๭ದ

෮ತ౨ವඝ౬ ඩವൟಸತಕౙൿ౪.

(3) ಈ ಃಳಉಡ ಷರൡ౨ಗಳඝ౬ තซ๭ದฉ ෥ತ౳ (1) ඡ ಉಪඛಯಮದ ಅലಯย౵

෮ತ౨ವඝ౬ ෱೪ฆ ෥ಡತಕౙൿ౪, ಎಂದฉ: -

(ಎ)ಅ೧ბർರರ

ඣೕಂದ൐ಯ

ൽකಂಕൽಂದ

ಆತඝ

ಅ೧ბ

ಸย౵๭ದ

ൽකಂಕದವฉಡ ಕඛಷ౤ ಒಂൿ ವಷბ ಗൟ๭ರ෎ಀ.

(෈) ඣೕಂർ෵ತ ෪ತ ಅಥ฿ ๸තಣბ฿ಜ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲ ຄಂൽದ

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಇಬ౯ฆ ಮಕౙัಡ ෥ತ౳.

(4) ಉಪ-ඛಯಮ (1)ರย౵ ඛൽბಷౣಪല๭ದ ෮ತ౨ದ ಃ౵ೕ෦ಛಜನ ಅ೧ბ෷ ನ෩ච-IX

ರย౵ರತಕౙൿ౪.

(5) ಪ౳๯౨ತ ಪ౳ๆಶ ಪഷದ ಮൡ౨ ಸ౽ბರൽಂದ ෥ನ౲൤ ಪഷದ ๸๲౩ಗಳย౵ ඛಯತ

ಆೕ๺ ბಗัಡ ಪ౳ๆಶ ಪഷದ เർ౲൮ბಗัಡ ෥ತ౳ ๖ౘ൐ಕ චರโ අฉಯತಕౙൿ౪:

ಪฏൡ, ಈ ๖ౘ൐ಕ චರโ ඀ರ ๏ౘಣ ಆೕ๺ ბಗำ, ಠಹ ಅಧ౲ಯನ ಆೕ๺ ბಗำ

ಆච౵ೖඨ ಆೕ๺ ბಗำ ෨ಂ൞ದโಗัಛಜ අฉಯತಕౙದ౪ಲ౵.

(6) ඛಯಮ 14ರ ಅലಯย౵ ಉಪීඌಸมದ ಪ౳෽ೕಜನโ ಈ ಫมඝಭเಗัಡ

ಅನ౷ಯ฿ಗತಕౙದ౪ಲ౵.

16. ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯคಡ ෥ൣತ౷

ಪ౳෽ೕಜನ:- (1) ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರโ, ನ෩ච-X ರย౵ನ ಅ೧ბಯ ෬ว,

ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯฆ ಮಞเನ ಜನನದ

ඬฃๅಯඝ౬ ๻ಜฆಪല๭ದ ತฆ฿ಯ, ෮ದಲ ಎರഴ ກคಡಗัಡ ෥ತ౳,

ಸ౽ბರโ

ಅඌ๰ಚචಯ

෩ಲಕ

ಅඌ๰೉๭ඈತಹ

෮ತ౨ವඝ౬

ಅವคಡ

෱೪ฆ ෥ಡತಕౙൿ౪.

(2) ಈ ಃಳಉಡ ಷರൡ౨ಗಳඝ౬ තซ๭ದฉ ෥ತ౳ ಈ ෮ತ౨ವඝ౬ ෱೪ฆ

෥ಡತಕౙൿ౪, ಎಂದฉ:-

(ಎ) ಅ೧ბർರฆ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฃಜ ෱ಡัಯย౵

ඣೕಂർ෵๭ದ ൽකಂಕൽಂದ ಮಞเನ ಜನನದವฉಡ ಕඛಷ౤ ಒಂൿ ವಷბ

ಗൟ๭ರತಕౙൿ౪;

9

(෈) ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბฆ ಈ

ಸ๻ಯವඝ౬ ಎರഴ ෇ค ෥ತ౳ ಪഷಯಬ๾ൿ ಮൡ౨ ಎರಡඡ ಃ౵ೕ෨

ಪഷ෷ವ ಅ೧ბ෽ಂൽಡ ಃ౵ೕ෨ ಎರಡඡ ກคಡಡ ಎಂൿ ൟั๯ವ

ಅඹಡเഡ ಇರತಕౙൿ౪;

(๭) ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ෱ಡัಡ

ඩವൟಸ෎౽ದ ෴โඃ ෇౾ಗಳඝ౬ ຄಂൽರತಕౙದ౪ಲ౵; ಮൡ౨

(ല) ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯคಡ ಈಛಗศ

ಇಬ౯ฆ ೧ೕ๋ತ ಮಕౙัದ౪ฉ ಅವคಡ ಈ ಸ๻ಯವඝ౬ ඛೕಡತಕౙದ౪ಲ౵.

17.

ඪಂಚ൐

෽ೕಜච,

ಅಹბ൤,

౽ಯბเඋನ

ಮൡ౨

ඪಂಚ൐ಯ

෱೪ฃൟ:- ฃಜ౲ ಸ౽ბರโ ඪಂಚ൐ಯ ಅಹბ൤, ౽ಯბเඋನ ಮൡ౨ ඪಂಚ൐

෱೪ฃൟಡ ๸ීඌ๭ದ ಷರൡ౨ಗಳඝ౬ ඛൽბಷౣಪലಸಬ๾ൿ.

18. ಅ೧ბ ಸย౵ಃಛಜ ౽ಲ ෦ൟ:-เเಧ ಃ౵ೕ෨ಗัಛಜ ಅ೧ბಗಳඝ౬ ಸย౵๯โದ౽ౙಜನ

౽ಲ෦ൟ෷ ಈ ಃಳಉഽൟರತಕౙൿ౪, ಎಂದฉ:-

ಕ౳ಮ

๸ಒ౲

ඛಯಮ

๸ಒ౲

ಪ౳෽ೕಜನಗำ

౽ಲ ෦ൟ

01

12

ಮರಣ,

ಅಂಗ็ಕಲ౲

ಮൡ౨

็ದ౲౾ೕಯ

ಮฆඩವൟಯ ๸ದಭბದย౵ ඣೕಂർ෵ತ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბคಡ

ಅಪಪತದ ಪ౳෽ೕಜನ.

ಅಪಪತದ

ൽකಂಕൽಂದ ಒಂൿ

ವಷბඅಳಡ

02

13

๬౷ූเಕ

ಮರಣದ

චರโ

(ಅಂತ౲౾౳෺

ๅಚ౞ಗิ ಒಳತಂഽ൤).

ಮರಣದ

ൽකಂಕൽಂದ ಆฆ

ൟಂಗูಳಡ.

03

14

ඣೕಂർ෵ತ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ චರโ.

ಪ౳ๆ๎ൟ

ൽකಂಕൽಂದ 6

ൟಂಗูಳಡ.

04

15

ಅಪಪತದ

౽ರಣൽಂർಜ

ಮರಣ

ຄಂൽದ/๸තಣბ ๎ಶ౷ತ ಅಂಗವ౲ಕಲ౲

ຄಂൽದ

ඣೕಂർ෵ತ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ

චರโ.

ಪ౳ๆ๎ൟ

ൽකಂಕൽಂದ 6

ൟಂಗูಳಡ.

05

16

ඣೕಂർ෵ತ

ಮ๼ะ

ಫมඝಭเಗัಡ

෥ൣತ౷ ಪ౳෽ೕಜನ.

ກคಡ ൽකಂಕൽಂದ

ಒಂಬൡ౨ ൟಂಗูಳಡ

06

17

ඪಂಚ൐ ෽ೕಜච

ಅඌ๰೉๭ඈ൤

19. ಅඪೕฤ:- (1) ඣೕಂದ൐ ಅඌ౽ค෷ ຄರല๭ದ ಆඃಶൽಂದ ෇ඌತฃದ

ඣೕಂർ෵ತ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბฆ,

ಆඃಶ

ຄರല๭ದ

ൽකಂಕൽಂದ ෩ವൡ౨ ൽನಗูಳಡ ಸ౽ბರโ ಅඌ๰೉๭ඈ൤ ಸ๻ಯಕ ౽෦ბಕ

10

ಆ෷ಕ౨ರ ದ೬ბಜಂತ ಕല෫ಯಲ౵ದ ಅඪೕฤ ඩ౳ඌ౽ರಃౙ ಅಂತಹ ಆඃಶದ เฆದ౫

ಅඪೕಲඝ౬ ಸย౵ಸಬ๾ൿ.

(2) ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರโ ಃ౵ೕ෨ಗಳඝ౬ ൟರಸౙค๯โದคಂದ ಅಥ฿ ಃ౵ೕ෨ಗัಡ

๸ීඌ๭ದ ෴โඃ ಀಂൿಆರ൤ಗัಂದ ෇ඌತฃದ ඣೕಂർ෵ತ ๭ඛ

ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ಅಂತಹ ಃ౵ೕ෨ಗಳඝ౬ ൟರಸౙค๭ದ ൽකಂಕൽಂದ

ಅರವൡ౨ ൽನಗูಳಡ ಸ౽ბರโ ಅඌ๰೉๭ඈ൤ ಅಂತಹ ಆඃಶದ เฆದ౫

ಅඪೕฤ ඩ౳ඌ౽ರಃౙ ಅඪೕಲඝ౬ ಸย౵ಸಬ๾ൿ.

(3)

ಅඪೕฤ

ඩ౳ඌ౽ರโ

เೈರൕಗಳ

ತฆ฿ಯ,

ಪค๻ರದ

ಆඃಶವඝ౬

ຄರല๯ವ ෩ಲಕ ಸದค ಅ೧ბಯඝ౬ เศ฿ค ෥ಡತಕౙൿ౪ ಮൡ౨

ඣೕಂದ൐ ಅಥ฿ ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರಃౙ ඛඃბಶನವඝ౬ ಸಹ ඛೕಡಬ๾ൿ:

ಪฏൡ, ಅඪೕฤ ඩ౳ඌ౽ರಃౙ, ಅඪೕฤർರඝ ಸ౽ಲಃౙ ಅඪೕಲඝ౬ ಸย౵ಸฤ

๬ಕ๠ౣ ಅഷತഷಗಳඝ౬ಅඝಭเ๭ർ౪චಂൿ ಮನದഓౣದฉ, ಅൿ ಸದค ಅವඌ

෨ಜದ ඦತರใ ಸಹಅඪೕಲඝ౬ ಅಂಜೕಕคಸಬ๾ൿ.

(4) ಅඪೕฤ ඩ౳ඌ౽ರโ ಅඪೕಲඝ౬ ๭౷ೕಕค๭ದ ൽකಂಕൽಂದ ൧ಂಬൡ౨ ൽನಗಳ

ಅವඌಯย౵ ಅದඝ౬ ಇತ౲ಥბಪലಸತಕౙൿ౪.

20. วಕౙಪค๗ೕಧච ಮൡ౨ วಕౙಪತ౳ಗಳ ඛವბಹൕ:-(1) ෱ಡั෷ ෱ಡัಯ

วಕౙಪತ౳ಗಳඝ౬ ๭ದ౫ಪലಸತಕౙൿ౪ ಮൡ౨ ඛವბ๼ಸತಕౙൿ౪ ಮൡ౨ ෱ಡั෷

ඡ෦๭ದ วಕౙಪค๗ೕಧಕฆ ವಷბಃౙ ಒ෫౱ วಕౙಪค๗ೕಧච ෥ಡತಕౙൿ౪.

(2) ෱ಡั෷ วಕౙಪค๗ೕಧಕರ ವರൽಯඝ౬ ๭౷ೕಕค๭ದ ತฆ฿ಯ ಆದ๠ౣ ෎ಗඡ

วಕౙಪค๗ೕಧಕರ ವರൽಯ ಪ౳ൟ෽ಂൽಡ ฿๞ბಕ วಕౙಪತ౳ದ เವರ൏ ಪഔౣಯ

ಪ౳ൟಯඝ౬ ฃಜ౲ ಸ౽ბರಃౙ ಕำ๼ಸತಕౙൿ౪.

(3) ฃಜ౲ ಸ౽ბರโ วಕౙಪค๗ೕಧಕರ ವರൽಯඝ౬ ಪค๏ೕย๭ದ ತฆ฿ಯ, ෱ಡัಡ

൞ඝ ๰ಕ౨ๅಂൿ ූเಸಬ๾ർඈಥ ඛඃბಶನಗಳඝ౬ ඛೕಡಬ๾ൿ ಮൡ౨

෱ಡั෷ ಅಂತಹ ඛඃბಶನಗಳඝ౬ ඩยಸತಕౙൿ౪.

21. ฿๞ბಕ ವರൽಗำ:- (1) ෱ಡั෷, วಕౙಪค๗ೕಧಕರ ವರൽ ೯൤ಡวಕౙಪค๗ೕඌತ

วಕౙಪತ౳ಗಳ ಪ౳ൟಗูಂൽಡ ฿๞ბಕ ವರൽಯඝ౬, ವಷბದ ෥ೖბ 31ฏൿ

ಆචತำ౶ವ

ಕึದ

ವಷბർವඌಯย౵ನ

෱ಡัಯ

౽ಯბದ

ಬಡ౛

ಅಗತ౲฿ಗಬ๾ർඈಥ ಒಂൿ ๬ෆౣ ಮൡ౨ ๻ി ბ ಪ౳ൟಯඝ౬ ನ෩ච-XIರย౵, ಪ౳ൟ

ವಷბ ಏඪ౳ฯ 1ರ ඦತರ ಆದ๠ౣ ෎ಗඡ ಮൡ౨ ല๲ಂಬฑ 31ฌಳಡ ಕකბಟಕ ฃಜ౲

เඋನ෱ಡಲಃౙ ಸย౵ಸತಕౙൿ౪.

22. วಕౙಪತ౳ಗำ, ඣೕಂದ൐ ಮൡ౨ ಇತರ ർಖวಗಳ ವ๼ಗำ.- (1) ෱ಡั෷ ನಗൿ

ค೧ಸౣฑ, ಆ๭౨ ค೧ಸౣฑ ಮൡ౨ ಎม౵ วಕౙಪತ౳ಗಳ ವ๼ಗಳඝ౬ ඛವბ๼ಸತಕౙൿ౪.

(2) ෱ಡั෷ඛಯಮ 20 ಮൡ౨ 21ರย౵ ඛൽბಷౣಪല๭ದ ಉං౪ೕಶ౽ౙಜ ಅಗತ౲฿ದ

วಕౙಪತ౳ಗಳ ವ๼ಗಳඝ౬ ඛವბ๼ಸತಕౙൿ౪.

(3) ෱ಡั෷ ඣೕಂದ൐ ಮൡ౨ ಃ౵ೕ෨ಗಳ ಎม౵ ದ൞౨ಂಶವඝ౬ เൿ౲ක౱ನ

งಪದย౵ ๯ರ౾౹ತ฿ಜ ඛವბ๼ಸತಕౙൿ౪.

11

(4) ෱ಡั෷ ൞ඝ ಅಗತ౲ๅಂൿ ූเಸಬ๾ർඈಥ ർಖวಗำ ಮൡ౨

ค೧ಸౣฑ ಗಳඝ౬ ඛವბ๼ಸಬ๾ൿ.

(5) ඣೕಂದ൐ ඩ౳ඌ౽ರ ಮൡ౨ ಃ౵ೕ෨ಗಳ ඩ౳ඌ౽ರโ ಅ೧ბർರฆ ಅಥ฿ ๭ඛ

ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბฆ ಸย౵๭ದ ಎม౵ ർಖวಗಳඝ౬ ඛವბ๼ಸತಕౙൿ౪

ಮൡ౨ ಉನ౬ತ ඩ౳ඌ౽ರಃౙ ಅಗತ౲เർ౪ಗวม౵ ಆ ർಖวಗಳඝ౬ ಒದಜಸತಕౙൿ౪.

******

ನ෩ච-1

(7ඡ ඛಯಮದ (1)ඡ ಉಪ-ඛಯಮ ඣೕല)

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫෱ಡัಯย౵

ඣೕಂದ൐ಛಜ ಅ೧ბ

ಡ,

ඣೕಂದ൐ ಅඌ౽ค

01

ກಸฆ ಆඋฑ ನย౵ದ౪ಂ൤

02

൪ං/ಪൟ/ಪൟ౬ಯ ກಸฆ:

03

ಌ฀ เะಸ:

_______ ൞ล౵ಀ________ ೧ว౵ ____

____ ฃಜ౲ _____

ඪඨ ಆೕി ----

03(ಎ)

เඋನಸූ ಃ౹ೕತ౳

04

ಪ౳๯౨ತ เะಸ

_______ ൞ล౵ಀ________ ೧ว౵ ____

____ ฃಜ౲ _____

ඪඨ ಆೕി ----

05

෷ಎಎඨ ๸ಒ౲ (ಇ-ಶ౳ෳ

ඣೕಂದ൐-๸ಒ౲)

05(ಎ)

ಆඋฑ ๸ಒ౲

05(෈)

ಪലತರ ೉ೕഔಯ เಧ ಮൡ౨

๸ಒ౲

ಎඪಎฯ/෈ඪಎฯ ಮൡ౨ ๸ಒ౲

06

ยಂಗ

ඬฆಷ/ ෈ඪಎฯ ಮൡ౨ ๸ಒ౲

07

ಜನ౱ ൽකಂಕ

ൽකಂಕ / ൟಂಗำ / ವಷბ

08

ಧಮბ

๼ಂ඀/෨๭౵ಂ/౾౳๏౞ಯඨ/ಇತฉ

08(ಎ)

೦ൟ

ಎ๺ ๭/ಎ๺ ഔ/ಓ෈๭/ ๬෥ನ౲

10

๖ౘ൐ಕ เർ౲ಹბ൤

ಅನౘರ๲౨/ඩ౳ಥ෦ಕ ๎ว/ ಮಧ౲෦ಕ

๎ว/10ඡ/೧೨ඡ

ತರಗൟ/ಐഔಐ/ല඲౵ೕಮ/๬౬ತಕ

ಪದเ/๬౬ತಆೕತರ ಪದเ

12

11

ಃಲಸದ ಸ౷งಪ

෱ಡั෷ ಞฆൟ๭ದ ಪഔౣಯ ಪ౳౽ರ

12

ඣೕಂದ൐ಯ ಸಮಯದย౵

ಃಲಸದ ಅඝಭವ

ವಷბ ಮൡ౨ ൟಂಗำ

1೩

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბฃಜ/๸๲౩෴ಜ

ಃಲಸ ෥ഴൟ౨ฆเฃ?

ຆൿ/ ಇಲ౵

1೩(ಎ)

ຆൿ ಆಜದ౪ฉ

ಎ) ಉඅ౲ೕಗർತನ ກಸฆ.

෈) ๸ಪಕბ ๸ಒ౲ಯ ಸ๼ತ฿ಜ เะಸ.

๭) ൽನಟย

ല) ෥๭ಕ ๆತನ

14

කಮඛඃბ๏ತರ เವರಗำ.

ಕ౳ಮ ๸ಒ౲:

ກಸฆ:

ยಂಗ:

๸ීಧ:

൪ං/൞෵/ಪൟ/ಪൟ౬/ಮಗ/ಮಗำ

ವಯ๯౺:

็฿๼ಕ๭౩ൟ:

15

ಆඋฑ ಡ ೯ೕലಸมದ

෇౲ಂಋ ಌ൤ ๸ಒ౲

෬ಲౙಂಡ ಎม౵ ෥๼ൟಗำ ಮൡ౨ ಸย౵๭ದ ർಖวಗำ ನನಡ ൟัൽฆವ ಮൡ౨

කඝ ඦ්ವಷౣರ ಮഔౣಡ ඛಜ฿ಜๅ ಮൡ౨ ಸค෴ಜๅ ಎಂൿ කඝ ಈ ෩ಲಕ

ಳೕ๞๯൤౨ೕච.

๬ವბಜඛಕ

ඩ౳ඌ౽ರಃౙ

๯ำ౶

෥๼ൟಯඝ౬

ಒದಜ๯โൿ

ಅಪฃಧๅಂ්ದඝ౬

ಮൡ౨

ಅದ౽ౙಜ

ನನ౬

෬ว

౽ඞඝ

ಕ౳ಮ

ಜฆಜಸಬ๾ංಂ්ದඝ౬ ಸಹ කඝ ൟัൿಆಂലฆ൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಅ೧ბർರನಸ๼/ ಎಡಣ ກ෍౯ഔౣನ ಞฆൡ

ಅභ สೕി ෥ಡ෎౽ದ ർಖวಗำ



ූವ೉ತ౳



ඥಕರನ ಞฆൟನ ೉ೕഔ/ ಉඅ౲ೕಗ ಪ౳෥ಣ ಪತ౳ (๸๲౩ಯย౵ ౽ಯბඛವბ๼๯ൟ౨ದ౪ฉ)

13

๭౷ೕಂൟ

๏౳ೕಮൟ/๏౳ೕ ………………. ಅ೧ბ๸ಒ౲………………………ൽකಂಕ………………ಇವฆ ಕකბಟಕ ๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯย౵

ඣೕಂದ൐ಛಜ

ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಅ೧ბ ಮൡ౨ තರಕ ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽ค ಸ๼ ಮൡ౨ ෮ಹฆ

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

ಕකბಟಕ

๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯย౵

ඣೕಂದ൐ಛಜ ൽකಂಕ: _________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲__________ ಮൡ౨ ർಖวಗำ

ൣඪ౨ಕರ฿ಜๅ. ಆൿದคಂದ, කඝ ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ

ಃ౹ೕ෥෗ไൽ౫ ෱ಡัಯย౵ ౽෦ბಕನඝ౬ ඣೕಂർ෵๭ಆಂലං౪ೕච.

ಸ౩ಳ:

ൽකಂಕ: ඣೕಂದ൐ ඩ౳ඌ౽ರದ ಸ๼

ಈ ಃಳಉಡ ౽ರಣಗัಛಜ, ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯย౵ ඣೕಂದ൐ಛಜ ൽකಂಕ ____________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲

______________ ಅඝ౬ ൟರಸౙค๭ං౪ೕච.

1.

2

3.

ಸ౩ಳ:

ൽකಂಕ: ඣೕಂದ൐ ඩ౳ඌ౽ರದ ಸ๼

14

ನ෩ච-II

(ඛಯಮ7ರ ಉಪඛಯಮ (1)ඝ౬ ඣೕല)

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ಉඅ౲ೕಗ ಪ౳෥ಣಪತ౳

๏౳ೕ/๏౳ೕಮൟ/ ಀ ------------ ಄ฑ ಆෆ ___________ ರವฆ ________________ ಎಂಬย౵

฿๭๯ൟ౨ൿ౪ ____________ ವಷბ __________ ൟಂಗัඛಂದ ನಮ౱ ๸๲౩ಯย౵ _____________ ಆಜ

౽ಯბඛವბ๼๯ತ౨ർ౪ฉ. ಆತ/ಆಃ෷ ง.__________ ಗಳ ൽನಟย/෥๭ಕ ๆತನವඝ౬

ಪഷ෷ൟ౨ർ౪ฉ

ನಮ౱ ๸๲౩ಯ เವರಗำ ಈ ಃಳಉഽൟๅ:

1. ๸๲౩/๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ກಸฆ:

2. ๸๲౩/๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ เะಸ:

3. ๸ಪ౾ბಸ෎౽ದ ವ౲౾౨ಯ ກಸฆ/ශೕඨ/෮ාฯ ๸ಒ౲:

4. ඥಕರನ ಞฆൟನ ೉ೕഔ (ಲಭ౲เದ౪ฉ) ಮൡ౨ ನಮ౱ ๸๲౩ಯย౵ ಃಲಸಃౙ ๳คದ ൽකಂಕ:

ಸ౩ಳ:

ൽකಂಕ: ಉඅ౲ೕಗർತ/๸๲౩ಯ ಸ๼ ಮൡ౨ ෮ಹฆ

15

ನ෩ච- III

[7ඡඛಯಮದ (3) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

"ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡัಯย౵ನ

ඣೕಂದ൐ಯ ನเೕಕರಣ౽ౙಜ ಅ೧ბ

ಇವคಡ,

ඣೕಂದ൐ ಅඌ౽ค

ඣೕಂದ൐ಯ เವರಗಳย౵ ಇಂൽೕಕคಸ෎౽ൿದඝ౬ ಞฆൡ ෥ല

01

ඣೕಂದ൐ ๸ಒ౲ ಮൡ౨

ඣೕಂದ൐ಯ ൽකಂಕ

02

๼ಂൽನ ඣೕಂದ൐ ಅඌ౽คಯ

เವರಗำ

03

ಅඋฑ ನย౵ฆ๋൤ ກಸฆ

04

൪ං/ಪൟ/ಪൟ౬ಯ ກಸฆ

05

ಌ฀ เะಸ

൞ล౵ಀ ----- ೧ว౵ ----

_______ ฃಜ౲ _______ ඪඨ

ඪඨ _________

05

(ಎ)

เඋನಸූ ಃ౹ೕತ౳

06

ಪ౳๯౨ತ เะಸ

൞ล౵ಀ ----- ೧ว౵ ----

_______ ฃಜ౲ _______ ඪඨ

ඪඨ _________

07

෷ಎಎඨ ๸ಒ౲

(ಇ- ಶ౳ෳ ඣೕಂದ൐ ๸ಒ౲)

ಬದม෵ಸฤ

๬ಧ౲เಲ౵

08

ಆඋฑ ๸ಒ౲

ಬದม෵ಸฤ

๬ಧ౲เಲ౵

08

(ಎ)

ಪലತರ ೉ೕഔಯ เಧ ಮൡ౨

๸ಒ౲

ಎඪಎฯ /෈ඪಎฯ

09

ยಂಗ

10

ಜನ౱ ൽකಂಕ

11

ಧಮბ

12

೦ൟ

13

๖ౘ൐ಕ เർ౲ಹბ൤

14

ಃಲಸದ ಸ౷งಪ

15

ඣೕಂದ൐ ಸಮಯದย౵ ಃಲಸದ

ಅඝಭವ

16

16

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರಬั/ ๸๲౩ಯย౵

౽ಯბඛವბ๼๯ൟ౨ฆเฃ?

ຆൿ/ಇಲ౵

16

(ಎ)

ຆൿ ಎಂർದฉ

ಎ) ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರ ກಸฆ

෈) ๸ಪಕბ

๸ಒ౲෽ಂൽಡ เะಸ

๭) ൽನಟย

ല) ෥๭ಕ ๆತನ

17

කಮඛඃბ๏ತನ เವರಗำ

ಕ౳ಮ ๸ಒ౲:

ກಸฆ:

ยಂಗ:

๸ීಧ:

൪ං/ ൞෵/ ಪൟ/ ಪൟ౬/

ಮಗ/ ಮಗำ:

ವಯ๯౺:

็฿๼ಕ ๭౩ൟ:

18

ಆඋฑ ಡ ยಂಋ ಆಜฆವ

෇౲ಂಋ ಌ൤ ๸ಒ౲

෬ಲౙಂಡ ಎม౵ ෥๼ൟಗำ ಮൡ౨ ಸย౵๭ದ ർಖวಗำ ನನಡ ൟัൽฆವ ಮൡ౨

කඝ ඦ්ವಷౣರ ಮഔౣಡ ඛಜ฿ಜๅ ಮൡ౨ ಸค෴ಜๅ ಎಂൿ කඝ ಈ ෩ಲಕ

ಳೕ๞๯൤౨ೕච.

๬ವბಜඛಕ

ඩ౳ඌ౽ರಃౙ

๯ำ౶

෥๼ൟಯඝ౬

ಒದಜ๯โൿ

ಅಪฃಧๅಂ්ದඝ౬

ಮൡ౨

ಅದ౽ౙಜ

ನನ౬

෬ว

౽ඞඝ

ಕ౳ಮ

ಜฆಜಸಬ๾ංಂ්ದඝ౬ ಸಹ කඝ ൟัൿಆಂലฆ൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಅ೧ბർರನ ಸ๼/ ಎಡಣ ກ෍౯ഔౣನ ಞฆൡ

ಅභ สೕി ෥ಡ෎౽ದ ർಖวಗำ



ූವ೉ತ౳



ඥಕರನ

ಞฆൟನ

೉ೕഔ/ಉඅ౲ೕಗ

ಪ౳෥ಣ

ಪತ౳

(ಒಂൿ

ๆึ

๸๲౩ಯย౵

౽ಯბඛವბ๼๯ൟ౨ದ౪ฉ)

17

๭౷ೕಂൟ

๏౳ೕಮൟ/๏౳ೕ ………………. ಅ೧ბ๸ಒ౲………………………ൽකಂಕ………………ಇವฆ "ಕකბಟಕ ๭ඛ

ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯย౵ನ

ඣೕಂದ൐ಯ

ನเೕಕರಣ౽ౙಜ ಅ೧ბಯඝ౬ ಸย౵๭ർ౪ฉ. ಅ೧ბ ಮൡ౨ ಅದರ තರಕ ർಖวಗำ

ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽ค ಸ๼ ಮൡ౨ ෮ಹฆ

෱೪ฃൟ / ൟರಸౙರൕಆඃಶ

"ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡัಯย౵ನ

ඣೕಂದ൐ಯ

ನเೕಕರಣ౽ౙಜ

ൽකಂಕ:

_________

ฏൿ

ಸย౵๭ದ

ಮൡ౨

ಅ೧ბ

๸ಒ౲__________ ർ๬౨ๆ೩ಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ "ಕකბಟಕ ๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ಃ౹ೕ෥෗ไൽ౫

෱ಡัಯย౵

౽෦ბಕನඝ౬

ඣೕಂർ෵๭ං౪ೕච.

ಸ౩ಳ:

ൽකಂಕ: ඣೕಂದ൐ ඩ౳ඌ౽ರದ ಸ๼

________________________________________________________________________________________________

________________ ಈ ಃಳಉಡ ౽ರಣಗัಛಜ, කඝ ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡัಯย౵ ඣೕಂದ൐ಯ ನเೕಕರಣ౽ౙಜ ಸย౵๭ದ

ಅ೧ბಯ ๸ಒ౲ _______________ ൽකಂಕ ____________ ಅඝ౬ ൟರಸౙค๭ං౪ೕච.

1.

2

3.

ಸ౩ಳ:

ൽකಂಕ: ඣೕಂದ൐ ඩ౳ඌ౽ರದ ಸ๼

18

ನ෩ච- IV

[7ඡඛಯಮದ (6) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫෱ಡั

ಞฆൟನ ೉ೕഔ

ಕකბಟಕ ಸ౽ბರ ౽෦ბಕ ಇมಒ

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫෱ಡั,

෍ಂಗิฆ

ಞฆൟನ ೉ೕഔ

ඣೕಂದ൐ಯ ൽකಂಕ ಮൡ౨

ඣೕಂದ൐ಯ ෨౽౨ಯದ

ൽකಂಕඅಂൽಡ ඣೕಂದ൐ಯ ๸ಒ౲

:

ກಸฆ

:

൪ං/ಪൟ/ಪൟ౬ಯ ກಸฆ

:

ยಂಗ

:

ಜನ౱ ൽකಂಕ

:

ไൟ౨

:

เะಸ

:

෮ාฯ ๸ಒ౲

:

౽෦ბಕ ಸ๼/ಎಡಣ ກಬ౯ರัನ ಞฆൡ ඣೕಂದ൐ ಅඌ౽คಯ ಸ๼

ූವ೉ತ౳

19

ನ෩ච-V

[12ඡ ඛಯಮದ (3)ඡ ಉಪ-ඛಯಮವඝ౬ ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಅಪಪತ ಮರಣದ ๸ීಧ

ಃ౵ೕෳ ಛಜ ಅ೧ბ

ಅ೧ბ ๸ಒ౲:

ಇವคಡ,

ಃ౵ೕ෨ ඩ౳ඌ౽ರ,

1.

ಅ೧ბർರ /කಮ ඛඃბ๏ತನ ็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ฆ๋൤ ກಸฆ

2. ಜನ౱ ൽකಂಕ ಮൡ౨ ವಯ๯౺

3. ಆඋฑ ๸ಒ౲

4. ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბฌಂൽಜನ ๸ීಧ

5. เะಸ

ಌ฀

ಪ౳๯౨ತ

6. ෮ාฯ ๸ಒ౲

7. ಅಪಪತ ๸ಭเ๭ದ ൽකಂಕ

8. ಮರಣ ຄಂൽದ ൽකಂಕ

2.

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ඣೕಂದ൐ เವರಗำ:

 ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბನ ກಸฆ

 ඣೕಂದ൐ ๸ಒ౲

 ൪ං/ಪൟ/ಪൟ౬ಯ ກಸฆ:

 ಜನ౱ ൽකಂಕ ಮൡ౨ ವಯ๯౺:

 ไൟ౨:

3.

ಅ೧ბർರ/ කಮ ඛඃბ๏ತನ ෇౲ಂಋ เವರಗำ

 ෇౲ಂಋ ກಸฆ

 ๎ಒಯ ກಸฆ

 ಆඋฑ ยಂಋ ಆಜฆವ ಌ൤

๸ಒ౲

 ಐಎෆ ಎ๺ ๭ ಆೕി

4.

ಸย౵ಸมದ ർಖวಗಳ ಪഔౣ (ಎม౵ ඁുೕಂತ ಪ౳ൟಗำ)

ຆൿ/ಇಲ౵

 ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბನ ෩ಲ ඣೕಂದ൐

ಞฆൟನ ೉ೕഔ

 ಉඅ౲ೕಗ ಪ౳෥ಣಪತ౳

 ಎෆ ಐಆฑ ನಪ౳ൟ (๸ීಧಪಟౣ

඲ยೕ๺ ഢൕ෵ಂದ

ඁുೕಕค๭ฆโൿ)

ඣೕಂർ෵ತ

๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ූವ೉ತ౳

ಅ೧ბർರರ/

කಮඛඃბ๏ತರ

ූವ೉ತ౳

20

 ಮರ൘ೕತ౨ರ ವರൽ (๸ීಧಪಟౣ

඲ยೕ๺ ഢൕ෵ಂದ ಅಥ฿

ಆಸ౭൤౳෵ಂದ ඁുೕಕค๭ฆโൿ)

 ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბನ ಮರಣ ಪ౳෥ಣಪತ౳

 ಅ೧ბർರ/කಮඛඃბ๏ತ ಮൡ౨

෪ತನ ಆඋฑ ౽ി ბ ಪ౳ൟ

 ಪലತರ ೉ೕഔ (ಲಭ౲เದ౪ฉ)

 ෪ತನ ೧ೕ๋ತ ಸದಸ౲

ಪ౳෥ಣಪತ౳ (ಉർಯ

ಇมಒ෵ಂದ ඛೕലฆโൿ)

 ಅ೧ბർರನ/ කಮඛඃბ๏ತನ

ಆඋฑ ยಂಋ ಆಜฆವ ෇౲ಂಋ

ඩ๺ ්ಋ ಪ౳ൟ

කඝ ෬ว ಒದಜಸมದ เವರಗำ ನನ౬ ൟಳವัಃಯ ಮഔౣಡ ඛಜ฿ಜๅ ಮൡ౨

ಸค෴ಜๅ ಎಂൿ ಈ ෩ಲಕ ಳೕ๞๯൤౨ೕච ಮൡ౨ ಒಂൿ ๆึ ෬ยನ ෴โඃ

෥๼ൟ෷ ๯ึ౶ಂൿ ಅಥ฿ ඛಜ฿ಜಲ౵ๅಂൿ ಉഴීದย౵ ಅದ౽ౙಜ ನನ౬ඝ౬

ຄൕಛರನක౬ಜ ෥ಡಬ๾ංಂ්ൿ ನನಡ ൟัൽฆತ౨ං.

ಸ౩ಳ:

ൽකಂಕ: කಮ ඛඃბ๏ತನ ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ರವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________ ರย౵

ಅಪಪತದ ಪ౳෽ೕಜನ౽ౙಜ ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಆಕ๭౱ಕ ಮರಣದ ๷ಲಭ౲౽ౙಜ

ಸย౵๭ದ ಅ೧ბ ಮൡ౨ ಅದರ තರಕ ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽คಯ ಸ๼ ಮൡ౨ ෮ಹฆ

21

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

ಆಕ๭౱ಕ ಮರಣ ๷ಲಭ౲౽ౙಜ ൽකಂಕ __________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________

ಮൡ౨ ർಖวಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ ------- ವಷბಃౙ ಆಕ๭౱ಕ ಮರಣ ๷ಲಭ౲ದ

ಅലಯย౵ ------- งඩ෵ಗಳඝ౬ ๸ർಯ ෥ലං౪ೕච,

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

________________________________________________________________________________________________

____________________________________________________________________________________

ಈ ෨ಂൽನ ౽ರಣಗัಛಜ, ಆಕ๭౱ಕ ಮರಣದ ๷ಲಭ౲౽ౙಜ ൽකಂಕ _________ ฏൿ

ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬ කඝ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

22

ನ෩ච- VI

[12ඡඛಯಮದ (3) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბඛಡ ಅಪಪತൽಂದ ಉಂഓದ

๎ಶ౷ತ ಅಂಗ็ಕಲ౲/ ็ದ౲౾ೕಯ ๅಚ౞ ಮฆඩವൟಛಜ ಅ೧ბ

ಅ೧ბ ๸ಒ౲:

ಇವคಡ,

ಃ౵ೕ෨ ඩ౳ඌ౽ರ,

1.

ಅ೧ბർರ /ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ

็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ฆ๋൤ ກಸฆ:

2. ඣೕಂದ൐ ๸ಒ౲:

3. ไൟ౨:

4. ඣೕಂದ൐ ๸ಒ౲

5. ಜನ౱ ൽකಂಕ ಮൡ౨ ವಯ๯౺:

6. ಆඋฑ ๸ಒ౲

7. เะಸ

ಌ฀

ಪ౳๯౨ತ

8. ෮ාฯ ๸ಒ౲

9. ಅಪಪತ ๸ಭเ๭ದ ൽකಂಕ

10. ಃ౵ೕ෦ನ เಧ

็ದ౲౾ೕಯ

๎ಶ౷ತ

ಅಂಗ็ಕಲ౲

11. ಅಂಗ็ಕಲ౲ ಆಜದ౪ฉ, ็ದ౲౾ೕಯ

෱ಡั෷ ඛೕಡมದ ಅಂಗ็ಕಲ౲

ಪ౳෥ಣ ಪತ౳ ๸ಒ౲

12. ಅಂಗ็ಕಲ౲ದ ๕ಕಡ฿ฆ

2.

ಅ೧ბർರ/ ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ

෇౲ಂಋ เವರಗำ

 ෇౲ಂಋ ກಸฆ

 ๎ಒಯ ກಸฆ

 ಆඋฑ ยಂಋ ಆಜฆವ ಌ൤ ๸ಒ౲

 ಐಎෆ ಎ๺ ๭ ಆೕി

3.

ಸย౵ಸมದ ದ๬౨ๆ೩ಗಳ ಪഔౣ (ಎม౵ ඁുೕಂತ ಪ౳ൟಗำ) ຆൿ/ಇಲ౵

1. ඣೕಂದ൐ ಞฆൟನ ೉ೕഔ

2. ಉඅ౲ೕಗ ಪ౳෥ಣಪತ౳

3. ಎෆ ಐಆฑ ನ ಪ౳ൟ (๸ීಧಪಟౣ

඲ยೕ๺ ഢൕ෵ಂದ

ඁുೕಕค๭ฆโൿ)

4. ็ದ౲౾ೕಯ ෱ಡั෵ಂದ ඛೕಡมದ

ಅಂಗ็ಕಲ౲ ಪ౳෥ಣಪತ౳

ඣೕಂർ෵ತ

๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕತბರ

ූವ೉ತ౳

23

5. ಆಸ౭൤౳ಯ ෩ಲ ෈ฤ౵ಗำ ಮൡ౨

ನಗൿ ඩವൟ

(ರ๭ೕൽಗำ ෩ಲ ಪ౳ൟ)

6. ಆಸ౭൤౳෵ಂದ ෈ഴಗഷತಂಡ ಬಡ౛

๸ౘಪ౨ ๬ฃಂಶ ಪತ౳ (෩ಲ ಪ౳ൟ)

7. ಎಃ౺იೕ ಪ౳ൟಗำ (෩ಲ ಪ౳ൟ)

8. ಅ೧ბർರ/ඣೕಂർ෵ತ ౽෦ბಕರ

ಆඋฑ ౽ി ბನ ಪ౳ൟ

9. ಅ೧ბർರನ/ ඣೕಂർ෵ತ ౽෦ბಕರ

෇౲ಂಋ ඩ๺ ඬಸ౨ಕದ ಪ౳ൟ

කඝ ෬ว ಒದಜಸมದ เವರಗำ ನನ౬ ൟಳವัಃಯ ಮഔౣಡ ඛಜ฿ಜๅ ಮൡ౨

ಸค෴ಜๅ ಎಂൿ ಈ ෩ಲಕ ಳೕ๞๯൤౨ೕච ಮൡ౨ ෬ยನ ෴โඃ ෥๼ൟ෷

๯ึ౶ಂൿ

ಅಥ฿

ඛಜ฿ಜಲ౵ๅಂൿ

ಉഴීದ

ಪౘದย౵

ಅದ౽ౙಜ

ನನ౬ඝ౬

ຄൕಛರನක౬ಜ ෥ಡಬ๾ංಂ්ൿ ನನಡ ൟัൽฆತ౨ං.

ಸ౩ಳ:

ൽකಂಕ:

ಅ೧ბർರನ/ ඣೕಂർ෵ತ

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ

ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ರವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________ ರย౵

ಆಕ๭౱ಕ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲/ ็ದ౲౾ೕಯ ๅಚ౞ ಮฆඩವൟ ๷ಲಭ౲౽ౙಜ ಅ೧ბಯඝ౬

ಸย౵๭ฆ൞౨ฉ. ಅ೧ბ ಮൡ౨ ಅದರ තರಕ ದ๬౨ๆ೩ಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽คಯ ಸ๼ ಮൡ౨ ෮ಹฆ

24

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

ಆಕ๭౱ಕ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲/ ็ದ౲౾ೕಯ ๅಚ౞ ಮฆඩವൟ ๷ಲಭ౲౽ౙಜ ൽකಂಕ

__________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಮൡ౨ ದ๬౨ๆ೩ಗำ ൣඪ౨ಕರ฿ಜๅ.

๻ಛಜ, කඝ ------- ವಷბಃౙ ಆಕ๭౱ಕ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲/็ದ౲౾ೕಯ ๅಚ౞ ಮฆඩವൟ

๷ಲಭ౲౽ౙಜ ಅലಯย౵ ------- งඩ෵ಗಳඝ౬ ๸ർಯ ෥ലฆ൤౨ೕච,

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

________________________________________________________________________________________________

____________________________________________________________________________________

ಈ ෨ಂൽನ ౽ರಣಗัಛಜ, කඝ ಆಕ๭౱ಕ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲/ ็ದ౲౾ೕಯ ๅಚ౞

ಮฆඩವൟ ๷ಲಭ౲౽ౙಜ ൽකಂಕ _________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬

කඝ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

25

ನ෩ච- VII

[13ඡඛಯಮದ (2) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ ಸಹಜ ಮರಣದ ಃ౵ೕ෦ಛಜ

ಅ೧ბ

ಅ೧ბ ๸ಒ౲:

ಇವคಡ,

ಃ౵ೕ෨ ඩ౳ඌ౽ರ,

1.

ಅ೧ბർರ /කಮ ඛඃბ๏ತನ ็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ฆ๋൤ ກಸฆ

2. ಜನ౱ ൽකಂಕ ಮൡ౨ ವಯ๯౺

3. ಆඋฑ ๸ಒ౲

4. ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბඣೕಂൽಜನ ๸ීಧ

5. เะಸ

ಌ฀

ಪ౳๯౨ತ

6. ෮ාฯ ๸ಒ౲

2.

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನඣೕಂದ൐ เವರಗำ:

1. ກಸฆ

2. ඣೕಂದ൐ ๸ಒ౲

3. ൪ං/ಪൟ/ಪൟ౬ಯ ກಸฆ:

4. ಜನ౱ ൽකಂಕ ಮൡ౨ ವಯ๯౺:

5. ไൟ౨:

6. ಮರಣ ຄಂൽದ ൽකಂಕ:

3.

කಮ ඛඃბ๏ತನ ෇౲ಂಋ เವರಗำ



෇౲ಂಋ ກಸฆ



๎ಒಯ ກಸฆ



ಆඋฑ ยಂಋ ಆಜฆವ ಌ൤ ๸ಒ౲



ಐಎෆ ಎ๺ ๭ ಆೕി

4

ಸย౵ಸมದ ದ๬౨ๆ೩ಗಳ ಪഔౣ (ಎม౵ ඁുೕಂತ ಪ౳ൟಗำ) ຆൿ/ಇಲ౵

1.

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ ෩ಲ

ඣೕಂದ൐ ಞฆൟನ ೉ೕഔ

2.

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನಮರಣ

ಪ౳෥ಣಪತ౳

3.

ಅ೧ბർರ/කಮඛඃბ๏ತ ಮൡ౨ ෪ತನ

ಆඋฑ ౽ി ბ ಪ౳ൟ

4.

ಉඅ౲ೕಗ ಪ౳෥ಣಪತ౳

5.

ಉർಯ ಇมಒ෵ಂದ ඛೕಡมದ

ಀഖಂಬದ ೧ೕ๋ತ ಸದಸ౲ರ ಪ౳෥ಣಪತ౳

6.

ಪലತರ ೉ೕഔ (ಲಭ౲เದ౪ฉ)

ඣೕಂർ

෵ತ

౽෦ბಕರ

ූವ೉ತ౳

ಅ೧ბർರ/

කಮඛඃბ

๏ತನ

ූವ೉ತ౳

26

7.

ಅ೧ბർರನ/ කಮඛඃბ๏ತನ ಆඋฑ

ยಂಋ ಆಜฆವ ෇౲ಂಋ ඩ๺ ්ಋ ಪ౳ൟ

කඝ ෬ว ಒದಜಸมದ เವರಗำ ನನ౬ ൟಳವัಃಯ ಮഔౣಡ ඛಜ฿ಜๅ ಮൡ౨

ಸค෴ಜๅ ಎಂൿ ಈ ෩ಲಕ ಳೕ๞๯൤౨ೕච ಒಂൿ ๆึ ෬ยನ ෴โඃ ෥๼ൟ෷

๯ึ౶ಂൿ

ಅಥ฿

ඛಜ฿ಜಲ౵ๅಂൿ

ಉഴීದ

ಪౘದย౵

ಅದ౽ౙಜ

ನನ౬ඝ౬

ຄൕಛರನක౬ಜಸಬ๾ංಂ්ൿ ನನಡ ൟัൽฆತ౨ං.

ಸ౩ಳ:

ൽකಂಕ: කಮඛඃბ๏ತನ ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ರವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________ ರย౵

๬౷ූเಕ ๬โ ๷ಲಭ౲౽ౙಜ ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಅ೧ბ ಮൡ౨ ಅದರ තರಕ

ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽คಯ ಸ๼ ಮൡ౨ ෮ಹฆ

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

๬౷ූเಕ ๬โ ๷ಲಭ౲౽ౙಜ ൽකಂಕ __________ ರย౵ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________

ಮൡ౨ ർಖวಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ ------- ವಷბಃౙ ๬౷ූเಕ ๬โ

๷ಲಭ౲౽ౙಜ ๷ಲಭ౲ದ ಅലಯย౵ ------- งඩ

ಗಳඝ౬ ๸ർಯ ෥ലฆ൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

________________________________________________________________________________________________

ಈ ෨ಂൽನ ౽ರಣಗัಛಜ, ๬౷ූเಕ ಮರಣ ๷ಲಭ౲౽ౙಜ ൽකಂಕ _________ ฏൿ

ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

27

ನ෩ච- VIII

[14ඡඛಯಮದ (3) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ චರโ

ಅ೧ბ ๸ಒ౲:

ಡ,

ಃ౵ೕ෨ ඩ౳ඌ౽ค,

1. ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ ็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ඈ൤ ກಸฆ

2. ඣೕಂದ൐ ๸ಒ౲

3. ๾ഔౣದ ൽකಂಕ ಮൡ౨ ವಯ๯౺

4. ಆඋฑ ๸ಒ౲

5. ไൟ

6. ಅಂ೎ เะಸ

7. ෮ාฯ ๸ಒ౲

2. ಫมඝಭเ ಮಕౙಳ ๖ౘ൐ಕ เವರಗำ

ಕ౳ಮ

๸ಒ౲

เർ౲൮ბ

ಯ ກಸฆ

๾ഔౣ

ದ

ൽකಂ

ಕ

฿౲๸ಗ

෥ഴൟ౨ฆ

ವ ತರಗൟ

ಆඋฑ

๸ಒ౲

๎วಯ ກಸฆ,

เะಸ ಮൡ౨

๸ಪಕბ ๸ಒ౲

3. เർ౲൮ბಯ ෇౲ಂಋ เವರಗำ

 ෇౲ಂ౾ನ ກಸฆ

 ๎ಒಯ ກಸฆ

 ಌ൤ ๸ಒ౲

 ಐಎෆ ಎ๺ ๭ ಆೕി

4. ಸย౵ಸมದ ർಖวಗಳ ಪഔౣ:

1. ඣೕಂದ൐ ౽ിბ

2. ಪ౳๯౨ತ ವಷბದ ฿౲๸ಗ ಪ౳෥ಣಪತ౳

3. ๼ಂൽನ ವಷბ ಉൟ౨ೕಣბฃದ ಅಂಕಪഔౣ

4. ಅ೧ბർರ ಮൡ౨ เർ౲൮ბಯ ಆඋฑ

౽ി ბ ಪ౳ൟ

5. เർ౲൮ბಯ ಆඋฑ ยಂಋ ಆಜฆವ

෇౲ಂ౾ನ ඩ๺ ඬಸ౨ಕದ ಪ౳ൟ

เർ౲൮ბಯ

ූವ೉ತ౳

28

෬ว ඛೕലฆವ ෥๼ൟ෷ ನನ౬ ൟಳವัಃಯ ಮൡ౨ ඦ෈ಃಯ ಮഔౣಡ ಸค෴ಜං

ಮൡ౨ ಎರಡ౾ౙಂತ ກೋ౞ ಮಕౙำ ಇඃ คೕൟಯ ๷ಲಭ౲ವඝ౬ ಪഷൽಲ౵ ಎಂ්ർಜ කඝ

ಈ ෩ಲಕ ඁുೕಕค๯൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಅ೧ბർರರ ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ರವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________ ರย౵

๖ౘ൐ಕ ಆ൮ბಕ චರเಛಜ ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಸ๼ಗำ ๳คඈ൤ ಅ೧ბ ಮൡ౨

තರಕ ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽คಯ ಸ๼ ಮൡ౨ ෮ಹฆ

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

๖ౘ൐ಕ ಆ൮ბಕ චರเಛಜ ൽකಂಕ __________ ರย౵ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಮൡ౨

ർಖวಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ ------- ๖ౘ൐ಕ ಆ൮ბಕ චರเನ ๷ಲಭ౲ದ

ಅലಯย౵ ------- ವಷბದย౵ -------- งಗಳඝ౬ เർ౲൮ბಡ ඩವൟ๭ฆ൤౨ೕච,

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

________________________________________________________________________________________________

____________________________________________________________________________________

ಈ ෨ಂൽನ ౽ರಣಗัಛಜ, කඝ ๖ౘ൐ಕ ಆ൮ბಕ චರโ ๷ಲಭ౲౽ౙಜ ൽකಂಕ _________

ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

29

ನ෩ච-IX

[15ඡ ඛಯಮದ (4) ඡಉಪ-ඛಯಮವඝ౬ ඣೕല]

ಕකბಟಕ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ಅಪಪತದ ౽ರಣൽಂർಜ ෪ತฃದ/๎ಶ౷ತ ಅಂಗ็ಕಲ౲ಃౙ ಒಳಛದ

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಮಕౙัಡ ๖ౘ൐ಕ චರโ

ಅ೧ბ ๸ಒ౲:

ಡ,

ಃ౵ೕ෨ ಅඌ౽ರ,

1.

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನ ็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ඈ൤ ກಸฆ

2. ඣೕಂದ൐ ๸ಒ౲

3. ಆඃಶ ๸ಒ౲. ඛಯಮ (12) ರലಯย౵

ಃ౵ೕ෨ ෥ಡมದ ๷ಲಭ౲ಗำ

4. ๾ഔౣದ ൽකಂಕ ಮൡ౨ ವಯ๯౺

5. ಆඋฑ ๸ಒ౲

6. ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ

౽ಯბಕತბඣಂൽಜನ ๸ීಧ

7. ಅಂ೎ เะಸ

8. ෮ාฯ ๸ಒ౲

2.

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბನಮಕౙಳ เವರಗำ:

ಕ౳ಮ

๸ಒ౲

เർ౲൮ბ

ಯ ກಸฆ

๾ഔౣ

ದ

ൽකಂ

ಕ

฿౲๸ಗ

෥ഴൟ౨ฆ

ವ ತರಗൟ

ಆඋฑ

๸ಒ౲

๎วಯ ກಸฆ,

เะಸ ಮൡ౨

๸ಪಕბ ๸ಒ౲

1

2

3.

เർ౲൮ბಗಳ ෇౲ಂಋ เವರಗำ



෇౲ಂ౾ನ ඩ๺ ඬಸ౨ಕದย౵ฆ๋൤

เർ౲൮ბಯ ກಸฆ



෇౲ಂಋ ನ ກಸฆ



๎ಒಯ ກಸฆ



ಌ൤ ๸ಒ౲



ಐಎෆ ಎ๺ ๭ ಆೕി

4.

ಸย౵ಸมದ ർಖวಗಳ ಪഔౣ:

1. ಞฆൟನ ೉ೕഔ

2. ಪ౳๯౨ತ ವಷბದ ฿౲๸ಗ ಪ౳෥ಣಪತ౳

3. ๼ಂൽನ ವಷბ ಉൟ౨ೕಣბฃದ ಅಂಕಪഔౣ

4. ඛಯಮ (12) ರലಯย౵ ಃ౵ೕ෨ ෥ಡมದ

ಪ౳෽ೕಜನಗಳ ಆඃಶ ಪ౳ൟ

เർ౲൮ბಯ

ූವ೉ತ౳

30

5. ඣೕಂർ෵ತ ౽෦ბಕರ ಮൡ౨

เർ౲൮ბಯ ಆඋฑ ౽ി ბ ಪ౳ൟ

6. เർ౲൮ბಯ ಆඋฑ ยಂಋ ಆಜฆವ

෇౲ಂ౾ನ ඩ๺ ඬಸ౨ಕದ ಪ౳ൟ

෬ว ඛೕലฆವ ෥๼ൟ෷ ನನ౬ ൟಳವัಃಯ ಮൡ౨ ඦ෈ಃಯ ಮഔౣಡ ಸค෴ಜං

ಮൡ౨ ಎರಡ౾ౙಂತ ກೋ౞ ಮಕౙำ ಇඃ ತರದ ๷ಲಭ౲ವඝ౬ ಪഷൽಲ౵ ಎಂ්ದඝ౬ කඝ ಈ

෩ಲಕ ඁുೕಕค๯൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಅ೧ბർರನ/ ඣೕಂർ෵ತ ౽෦ბಕನ/

เർ౲൮ბಯ ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ಇವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________ ฏൿ

ಅಪಪತದ ౽ರಣൽಂದ ಮರಣ ຄಂൽದ/ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲ಆౙಳಛದ ඣೕಂർ෵ತ

౽෦ბಕคಡ ๖ౘ൐ಕ චರเಛಜ ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಸ๼ಗำ ๳คඈ൤ ಅ೧ბ ಮൡ౨

තರಕ ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಅඌ౽คಯ ಸ๼ ಮൡ౨ ෮ಹฆ

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

ಅಪಪತದ ౽ರಣൽಂದ ෪ತฃದ/ ๎ಶ౷ತ ಅಂಗ็ಕಲ౲ಆౙಳಛದ ඣೕಂർ෵ತ

౽෦ბಕರ ๖ౘ൐ಕ චರเಛಜ ൽකಂಕ __________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________

ಮൡ౨ ർಖวಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ ------- ವಷბದย౵ ಅಪಪತದ

౽ರಣൽಂർಜ ෪ತ/๎ಶ౷ತ ಅಂಕ็ಕಲ౲ಆౙಳಛದ ඣೕಂർ෵ತ ౽෦ბಕರ ๖ౘ൐ಕ

චರเನ ಅലಯย౵ ------- งඩ෵ಗಳඝ౬ ๸ർಯ ෥ലං౪ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

31

ಈ

෨ಂൽನ

౽ರಣಗัಛಜ,

කඝ

ಅಪಪತದ

౽ರಣൽಂർಜ

෪ತ/๎ಶ౷ತ

ಅಂಕ็ಕಲ౲ಆౙಳಛದ ඣೕಂർ෵ತ ౽෦ბಕರ ๖ౘ൐ಕ චರเನ ൽකಂಕ _________

ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

ನ෩ච- X

[16ඡඛಯಮದ (3) ඡಉಪ-ඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ඣೕಂർ෵ತ ಮ๼ะ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯคಡ ෥ൣತ౷

๷ಲಭ౲

ಅ೧ბ ๸ಒ౲:

ಡ,

ಃ౵ೕ෨ ඩ౳ඌ౽ค,

1

๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯ ็ಯ౾౨ಕ เವರಗำ:

1. ಆඋฑ ನย౵ฆ๋൤ ກಸฆ

2. ඣೕಂದ൐ ๸ಒ౲

3. ๾ഔౣದ ൽකಂಕ ಮൡ౨ ವಯ๯౺

4. ಆඋฑ ๸ಒ౲

5. ಉඅ౲ೕಗ

6. เะಸ

ಪ౳๯౨ತ

ಌ฀

7. ෮ාฯ ๸ಒ౲

2

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯ ກคಡ เವರಗำ:

1. ກคಡ෴ದ ൽකಂಕ

2. ಮಞเನ ยಂಗ

3. ๾ഔౣದ ಸ౩ಳ

4. ෮ದಲඡ/ಎರಡඡ ಮಞเಡ ಃ౵ೕ෨

෥ಡมಞൟ౨ං෻?

3

ඣೕಂർ෵ತ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕ൤ბಯ ෇౲ಂಋ เವರಗำ



෇౲ಂಋ ನ ກಸฆ



๎ಒಯ ກಸฆ



ಌ൤ ๸ಒ౲



ಐಎෆ ಎ๺ ๭ ಆೕി

4

ಸย౵ಸมದ ർಖวಗಳ ಪഔౣ:

1.

ඣೕಂದ൐ ౽ിბ

๭ඛ ಮൡ౨

๬ಂಸౙೃൟಕ

౽ಯბಕ൤ბಯ

ූವ೉ತ౳

32

2.

൞෵ ౽ിბ

3.

ಮಞเನ ಜನನ ಪ౳෥ಣ ಪತ౳

4.

ಆඋฑ ยಂಋ ಆಜฆವ ෇౲ಂ౾ನ

ඩ๺ ඬಸ౨ಕದ ಪ౳ൟ

5.

෴โඃ ಮಞเಛಜ ಈ ๼ಂං ಃ౵ೕ෨

෥ലಲ౵/ ಎರಡඡ ಮಞเನ ಃ౵ೕ෨

෥ഴൟ౨ฆโದඝ౬ ൟั๭ದ ಅඹಡเഡ

෬ว ൟั๭ฆವ ෥๼ൟ෷ ನನ౬ ൟಳವัಃಯ ಮൡ౨ ඦ෈ಃಯ ಮഔౣಡ ಸค෴ಜං

ಮൡ౨ කඝ ಎರಡ౾ౙಂತ ກೋ౞ ಮಕౙำ ಇඃ ತರದ ๷ಲಭ౲ವඝ౬ ಪഷൿಆಂലฆโൽಲ౵

ಎಂൿ ಈ ෩ಲಕ ඁുೕಕค๯൤౨ೕච.

ಸ౩ಳ:

ൽකಂಕ: ඣೕಂർ෵ತ ౽෦ბಕರ ಸ๼/ ກ෍౯ರัನ ಞฆൡ

๭౷ೕಂൟ

๏౳ೕಮൟ/ ๏౳ೕ ___________ ಇವฆ ಅ೧ბ ๸ಒ౲ ____________ ಅඝ౬ ൽකಂಕ_____________

෥ൣತ౷ ๷ಲಭ౲౽ౙಜ ಅ೧ბಯඝ౬ ಸย౵๭ฆ൞౨ฉ. ಅ೧ბ ಮൡ౨ ಅದಃౙ ๸ීඌ๭ದ තರಕ

ർಖวಗำ ಪค๏ೕಲචಡ ಒಳಪഔౣฆತ౨ๅ.

ಸ౩ಳ:

ൽකಂಕ: ಕ೏คಯ ෮ಹฆ ಮൡ౨ ಸ๼

෱೪ฃൟ / ൟರಸౙರൕ ಆඃಶ

෥ൣತ౷ ๷ಲಭ౲౽ౙಜ ൽකಂಕ __________ ฏൿ ಸย౵๭ದ ಅ೧ბ ๸ಒ౲ __________ ಮൡ౨

ർಖวಗำ ൣඪ౨ಕರ฿ಜๅ. ๻ಛಜ, කඝ ෥ൣತ౷ ๷ಲಭ౲ದ ಅലಯย౵ ------- ವಷბಃౙ

______________ งඩ෵ಗಳඝ౬ ๸ർಯ ෥ലං౪ೕච.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

33

ಈ ෨ಂൽನ ౽ರಣಗัಛಜ, ෥ൣತ౷ ๷ಲಭ౲౽ౙಜ ൽකಂಕ _________ ฏൿ ಸย౵๭ฆವ

ಅ೧ბ ๸ಒ౲ __________ ಅඝ౬ කඝ ൟರಸౙค๭ං౪ೕච.

1.

2.

3.

ಸ౩ಳ:

ൽකಂಕ: ಃ౵ೕ෨ ඩ౳ඌ౽คಯ ಸ๼

ನ෩ච- XI

[21ඡඛಯಮವඝ౬ඣೕല]

ಕකბಟಕ ๭ඛ ಮൡ౨ ๬ಂಸౙೃൟಕ ౽ಯბಕತბರ ಃ౹ೕ෥෗ไൽ౫ ෱ಡั

ವಷბದ ฿๞ბಕ ವರൽ

ಕ౳.

๸.

เವರಗำ

෥๼ൟ

1.

෱ಡัಯ ກಸฆ

2.

ರಚච෴ದ ൽකಂಕ

3.

ಅಧ౲ౘರ ກಸฆ

4.

෱ಡัಯ ಸದಸ౲ฆ

5.

ඩ౳ඃ๏ಕ ಕ೏ค (෴โർದง ಇದ౪ฉ)

6.

๔౳ೕ൐฿ฆ ෱ಡัಯ ๭ಬ౯ಂൽ ๸ಒ౲ (ඩ౳ඃ๏ಕ

ಕ೏ค෸ ๳คඈ൤)

7.

෱ಡัಯย౵ನ ඣೕಂർ෵ತ ಫมඝಭเಗಳ

๸ಒ౲

8.

ವಷბದ ಅವඌಯย౵ ඣೕಂದ൐෴ದ

ಫมඝಭเಗಳ ๸ಒ౲

9.

ವಷბದ ಅವඌಯย౵ ನഷದ ಸොಗಳ ๸ಒ౲ಯඝ౬

ൽකಂಕಗูಂൽಡ ൟั๭ ಮൡ౨ ನഷವัಗಳ ಪ౳ൟ

ಲಗൟ౨๭

10.

ಪ౳๯౨ತ ವಷბದ วಕౙಪค๗ೕಧචಯ ๗ೕಧචಗำ

11.

๼ಂൽನ ವಷბದ วಕౙ ಪค๗ೕಧක ๗ೕಧචಗಳ

ಬಡ౛ ൤ಡൿಆಳ౶มದ ಅඝඩಲච

12.

ಆ൮ბಕ เವರ ಪഔౣಗูಂൽಡ ಆಂತคಕ

วಕౙಪค๗ೕಧක ವರൽಯඝ౬ ಲಗൟ౨๯โൿ

13.

๼ಂൽನ ವಷბದย౵ನ ಆಂತคಕ วಕౙಪค๗ೕಧಕರ

๏මರ๯౺ಗำ ಮൡ౨ ಅඝಸರൕಗำ

14.

෥ೖ ბ-31 ರ ಆචಯย౵ದ౪ಂ൤ ನಗൿ ಮൡ౨

෇౲ಂಋ ๏ฤౙ (ಒಂದ౾ౙಂತ ກೋ౞ ෇౲ಂಋ

ಌ൤ಗัದ౪ฉ, ಪ౳൤౲ೕಕ฿ಜ ನ෩ൽ๭)

34

15.

ಚರ ಮൡ౨ ๭౩ฃ๭౨ಯ เವರಗำ

16.

ಅඌඛಯಮದ ಪ౳ಕರಣ 14ರ ಪ౳౽ರ ವಷბದ

ಅವඌಯย౵ನ ๭౷ೕಂൟಗำ (ಜ෫ಗำ)

17.

ಅඌඛಯಮದ ಪ౳ಕರಣ 15ರ ಪ౳౽ರ ๅಚ౞

(෽ೕಜච฿ฆ ಮൡ౨ ಇತರ ๅಚ౞ದ เವರಗಳඝ౬

๰೉๭)

18.

ක౲෴ಲಯದ ಪ౳ಕರಣ ෴โർದง ಇದ౪ฉ

ಅದರ เವರಗำ

19.

ಈ ವಷბದย౵ ಸ౽ბರಃౙ ಕำ๼๭ದ ಪ౳๬౨ವචಗำ

ಕකბಟಕ ฃಜ౲ඩಲರ ಆඃ๎ඝ๬ರ

ಮൡ౨ ಅವರ ກಸคನย౵

๯ಮ.ಎ๺

ಸ౽ბರದ ಅඌೕನ ౽ಯბದ๏ბ

౽෦ბಕ ಇมಒ

GOVERNMENT OF KARNATAKA

NO: LD 386 LET 2023

Karnataka Government Secretariat,

Vikasa Soudha,

Dr.B.R. Ambedkar Veedhi,

Bangalore, dated: 03/11/2025

NOTIFICATION

Whereas the draft of the Karnataka Cine and Cultural Activists Social

Security and Welfare Rules, 2025 was published in notification no: LD 386 LET

2023, dated: 24-09-2025 in part of the Karnataka Gazette dated: 24-09-2025, as

required by sub-section (1) of the said section inviting objections or suggestions

from all the persons likely to be affected there by within thirty (30) days from the

date of its publication in the official gazette.

And whereas the said gazette was made available to the public on 24-09-

2025.

And whereas objections and suggestions received in this behalf have been

considered by the State Government.

Now, therefore, in exercise of the powers conferred by sub-section (1) of the of

the Karnataka Cine and Cultural Activists Social Security and Welfare Rules, 2025

the Government of Karnataka hereby makes the following rules, namely: -

Karnataka Cine and Cultural Activists Social Security and Welfare Rules,

2025.

35

1. Title, commencement and application:- (1) These rules may be called the

Karnataka Cine And Cultural Activists social security and (Welfare) Rules, 2025.

(2) They shall come into force from the date of their final publication in the

Official Gazette.

(3) They shall apply to every undertaking as defined in clause (o) of section 2

of the Act.

2. Definition:- (1)In these rules, unless the context otherwise requires

a. “Act” means the Karnataka Cine And Cultural Activists (Welfare) Act,

2024 (Karnataka Act 46 of 2024);

b. “Accident” means an event which is occurred suddenly without

criminal intention and unforeseen act resulting in death or

incapacitation leading to permanent or total or partial disablement;

c. “Employer” means the person who employs directly or indirectly the

Cine and Cultural Activist;

d. “Chairperson” means the Chairperson of the Board;

e. “Member” means a member of the Board; and

f. “Section” means a section of the Act.

(2) All other words and expressions used but not defined shall have the same

meaning as assigned to them in the Act.

3. Allowances of members:- (1) The traveling allowance of an official member of

the Karnataka Cine And Cultural Activists’ Welfare Board shall be governed by

the rules applicable to him for journey performed by him on official duties and

shall be paid by the authority paying his salary.

(2) The non-official members of the Board shall be entitled to the payment of

traveling and daily allowance as per the provisions of Payment of Traveling

Allowance (to Non-official Members of Committees, Commissions or other

Bodies) Rules, 2001, Annexure-A of Karnataka Civil Services Rules.

4. Meeting:- (1) The Board shall meet at such places and at such times as may be

decided by the Chairperson but shall meet at least once in three months.

(2) Ordinarily, two weeks’ notice shall be given to the members of the Board of

a proposed meeting:

Provided that, the Chairperson, if he is satisfied that it is necessary so to do,

may give notice of longer period not exceeding one month for such meeting.

(3) No business except which is included in the list of business for a meeting

of the Board shall be considered at the meeting without the permission of

the Chairperson.

(4) The Chairperson may at any time call a special meeting of the Board in case

of urgency, after informing the members in advance about the subject-

matter of discussion and the reason of urgency.

36

5. Quorum:- (1) No business shall be transacted at any meeting of the Board unless

fifty percent of the Board members are present in that meeting:

Provided that, if at a meeting, less than fifty percent of members are present,

the Chairperson may adjourn the meeting to another date informing the members

present and giving notice to the other members that he proposes to dispose off the

business at the adjourned meeting whether there is quorum or not, and it shall

there upon he can transact the business at the adjourned meeting irrespective of

the number of members attending.

(2) The State Government may prohibit any member, other than ex-officio

members, from taking part in the Meeting of the Board if,-

a. The member absents himself from three consecutive meetings of the

Board without written information and consent of the Chairperson; or

b. The member in the opinion of the State Government has ceased to

represent the interest which he purports to represent on the Board.

6. Appointment of Registering Officers:- The Government may, by order notify

in the official gazette:-

a. such persons, being officers of the Government not below the rank

of labour inspectors in the Labour Department as it thinks fit, to be

the Registering Officers to register cine and cultural activists for the

purposes of this Act;

b. define the limits within which a registering officer shall exercise the

powers conferred on him by the Act or under this Rules.

c. a digital portal shall be in place to carry out the registration process

along with integration of digital data from such similar portals.

7. Registration of Cine and Cultural Activists.- (1) The Cine and Cultural

Activists belonging to the age group of 18 to 60 years and categories mentioned

in clause(e) of section 2 of the Act shall apply in Form I to the registering officers

notified under clause (a) of rule 6 of along with his Address Proof, Aadhaar linked

Bank Passbook or E-shram (UAN), employee I.D Card (If available) or

employment certificate in Form II issued by the employer:

Provided that, the Cine and Cultural Activist applying shall perform Cine

and Cultural activity.

(2) The Registering Authority after satisfying that the applicant has complied

with the provisions of clauses (e)&(f) of section 2 of the Act and register

such Cine and Cultural activists as beneficiary of the schemes of the

Board and shall issue him an unique ID card and a receipt for the same.

The ID card is valid for a period of three years.

(3) The registration shall be renewed for every three years. Cine and Cultural

activists shall submit updated document regarding change of details if any

in Form III.

37

(4) The registration of the Cine and Cultural activists shall be cancelled by the

Registering Authority if such authority is satisfied that the registration has

been obtained by false statement or declaration or by suppression of fact

by fraud, after giving an opportunity of being heard to the affected Cine

and Cultural activists by the Registering Authority to put forth his defense

in the matter, before cancellation of his registration.

(5) The Registering Authority issues to every beneficiary an unique identity

card with photo of beneficiary in Form IV.

8. Collection and Assessment of cess.- (1) Two percent cess on Cinema Tickets

of all theatres including Multiplex Theatres.

(2) Two percent cess on total transaction of Television entertainment channels

operating in the State of Karnataka.

(3) Levying, assessment and collection of cess from establishments notified by

the Government from time to time will be done in such manner or such

time and such intervals as notified by the Government in the official

Gazette.

(4) The cess shall be collected by the Government and transferred to the Board

quarterly.

9. Grants in Aid from the Government.- Government grants to be allocated for

cultural activists other than cinema and Television channels activists.

10. Appointment of Collection Officer.- The Government may, by notification in

the official gazette,-

(a) appoint such persons, being officers of the Government not below

the rank of labour officers in the Labour Department as it thinks fit,

to be the Collecting Officers to collect the cess for the purposes of the

Act and these rules;

(b) specify the limits within which a Collection Officer shall exercise the

powers conferred on him by or under the Act and these rules;

(c) a digital portal shall be in place to carry out the collection process

along with integration of digital data from such similar portals.

11. Claims Authority.- The Government may, by notification in the official gazette,

appoint such officers of the State Government not below the rank of Labour

Officers in the Labour Department as it thinks fit, to be the Claims Authority.

12. Accident Benefit to the Registered Cine and Cultural Activists in case of

Death, Disability and Medical Reimbursement.- (1) the registered Cine and

Cultural activists shall be eligible for accident benefit in case of death, disability

and medical reimbursement:

Provided that, the same benefit shall also available in case of cardiac arrest

death (Heart attack) occurred while on duty.

38

(2) Every registered Cine and Cultural activists, who meets with an accident

during the course of his employment or outside the course of his/her

employment, shall be eligible for all accident benefits given by the Board

under these rules:

Provided that, a registered Cine and Cultural activists shall not be eligible

for accident benefits under these rules in following circumstances,-

(a) Natural Death.

(b) Payment of compensation in respect of death or injury as a

consequences of resulting from:-

(c) committing or attempting to commit suicide, intentional self injury;

(d) whilst under the influence of intoxicating liquor or drugs;

(e) committing any breach of law with criminal intent;

(3) Procedure for Claims shall be as follows, namely:-

a. Every registered Cine and Cultural activists or his first living nominee

who is eligible for accident benefit under sub-rule (2) shall apply to the

Claims Authority notified under rule 13 for death in Form V and for

accidental permanent disability or medical reimbursement in form VI

along with FIR, Post mortem report, living member certificate of

deceased and death certificate (in case of death), original medical bills

and discharge summary for medical reimbursement and medical

certificate issued by the taluk or district medical board showing clearly

the percentage of permanent total disablement (incapacitation) or

permanent partial disablement suffered by the applicant due to the

accident.

b. The Claims Authority shall examine every application for accident

benefit in accordance with the provisions of the act and these rules and

may accept or reject the claim:

Provided that, the Claim Authority in this behalf shall, before rejecting a

claim for accident benefit, give the applicant a reasonable opportunity of making

the representation.

c. The amount of compensation in case of death, permanent total

disablement and permanent partial disablement in proportion to the

percentage of disablement or hospital expenditure reimbursement shall

be as specified by the Government by notification.

13. Natural Death Assistance (Inclusive of Funeral expenses):- (1) If a registered Cine

and Cultural activists dies naturally, the Claims Authority shall pay such

amount as notified by the Government by notification from time to time to the

nominee of the deceased registered Cine and Cultural activists inclusive of

funeral expenses of the deceased registered Cine and Cultural activists.

(2) The application for claiming the amount specified in sub-rule (1) shall be

in Form VII and shall be accompanied by the death certificate of the deceased

registered Cine and Cultural activists Living member certificate issued by revenue

39

department, Aadhaar linked bank pass book and the original identity card issued

to the deceased Cine and Cultural activists or registration number of the

beneficiary for verification of validity and correctness by the Board in case of non

availability of original identity card.

14. Education Assistance to Children’s of registered Cine and Cultural

Activists:- (1) The Claims Authority may, on an applications made by a

registered Cine and Cultural activists in form-VIII, sanction every year for their

dependent children not exceeding two children, annual educational assistance

for the courses specified in the table.

Table

SL.

No.

Educational Courses

01

12^th or equivalent

02

Bachelor Degree or equivalent

03

LLB/Para Medical/B.Pharma/Nursing and other professional courses, as

specified by the State Government

04

MBBS/BE/B.Tech and Post Graduation courses

(2) The Claims Authority shall pay such amount as notified by the

Government by notification.

(3) Educational Assistance shall be available for the current enrolment and

only for the students enrolled in regular courses in institutions

recognized by the Government:

Provided that, Educational Assistance benefit shall not be available

for Distance Education Courses, Home Study Courses, Online Courses, etc.

15. Education assistance to the children of the deceased/total permanent

disabled registered Cine and Cultural Activist’s due to accident.- (1) The

Claims Authority may every year sanction annual educational assistance for

dependent children, not exceeding two children of the deceased Cine and

Cultural activists who succumbed to accidental death or permanent total

disablement for the courses specified in the table.

Table

SL.

No.

Name of Educational Courses

01

1^st Standard to Degree and equivalent

02

LLB/Para Medical/ B.Pharma/ Nursing and other professional courses etc.,

03

MBBS/BE/B.Tech and Post Graduation courses

40

(2) The Claims Authority shall pay such amount as notified by the by the

Government by notification from time to time.

(3) The amount under sub rule (1) shall be sanctioned only if the following

conditions are fulfilled, namely:-

a. A minimum of one year shall have lapsed from the date of registration

of the applicant to the date of his application.

b. Only two children of a registered deceased or totally permanent

disabled Cine and Cultural activists.

(4) The application for claiming the amount specified in sub-rule (1) shall be

in Form – IX.

(5) Educational Assistance shall be available for the current enrollment and

only for the students enrolled in regular courses in institutions

recognized by the Government:

Provided that, educational assistance shall not be available for Distance

Education Courses, Home Study Courses, Online Courses, etc.

(6) Benefit provided under rule 14 shall not be applicable to these

beneficiaries.

16. Maternity benefit to registered woman Cine and Cultural activists:-

(1) The Claims Authority on an application in form-X shall sanction such amount

as notified by the Government by notification, only for first two deliveries, to

the female registered Cine and Cultural activists on producing proof of

delivery of a child.

(2) The amount shall be sanctioned, only if the following conditions are fulfilled,

namely;-

a. A minimum of one year shall have lapsed from the date of registration

of the applicant as a Cine and Cultural activists with the Board, to the

delivery of the child;

b. A registered woman Cine and Cultural activists can get this assistance

only twice and that second claim application shall be accompanied by

an affidavit stating that the claim is for second delivery;

c. The registered woman Cine and Cultural activists shall have no dues

payable to the Board; and

d. The registered woman Cine and Cultural activists shall not be given this

assistance if she already has two living children.

17. Pension Scheme, eligibility, procedure and sanction of pension:- The

conditions regarding eligibility, procedure and sanction of pension as may be

specified by the State Government.

18. Time limit for submission of applications:- Time limits for submission of

applications for different claims shall be as follows, namely:-

41

Sl.

No.

Rule

No.

Benefits

Time Limit

01

12 Accident Benefit to the Registered Cine and

Cultural Activists in case of Death, Disability and

Medical Reimbursement.

Within

One

year

from the date of

accident.

02

13 Natural Death Assistance (Inclusive of Funeral

expenses).

Within six months

from the date of

death.

03

14 Education Assistance to Registered Cine and

Cultural Activists Children.

Within

6

months

from the date of

admission.

04

15 Education assistance to the children of the

deceased/total permanent disabled registered

Cine and Cultural Activists due to accident.

Within

6

months

from the date of

admission.

05

16 Maternity benefit to registered woman beneficiary. Within nine months

from the date of

delivery

06

17 Pension Scheme.

As notified

19. Appeal:- (1) A registered Cine and Cultural activists aggrieved by an order

passed by the Registering Officer may appeal against such order to the

Appellate Authority not below the rank of Assistant Labour Commissioners

as notified by the Government within thirty days of from the date of order

passed.

(2) A registered Cine and Cultural activists aggrieved by the rejection of claims

by the Claims Authority or any grievance regarding claims may appeal

against such order to the Appellate Authority as notified by Government

within sixty days from the date of rejection of such claims.

(3) The Appellate Authority, upon inquiries, dispose the said petition by passing

an order of redressed and may also issue a direction to the Registering or

Claims Authority:

Provided that, the Appellate Authority may admit the appeal after the expiry

of the said period of days if it is satisfied that the appellant was prevented by

sufficient cause from filing the appeal in time.

(4) The Appellate Authority shall dispose of the appeal with in the period of

ninety days from the date of receiving the appeal.

20. Maintenance of Audit and Accounts:- (1) The accounts of the Board shall be

prepared and maintained by the Board and shall be audited by the Auditors

appointed by the Board once a year.

(2) As soon as may be after the receipt of the report of the auditor, the Board

shall send a copy of the annual statement of accounts, together with

the copy of the report of auditor to the State Government.

42

(3) The State Government may, after perusal of the report of the auditor,

give such directions, as it thinks fit, to the Board and the Board shall

comply with such directions.

21. Annual Reports:- The Board shall submit to the Karnataka State Legislature

as soon as may be after the 1st of April every year and not later than 31st day

of December, an Annual Report in Form XI, a soft and hard copies as may be

required on the working of the Board during preceding year ending on 31st

march of the year along with audited copies of Accounts together with an

auditor’s report.

22. Books of accounts, register and other records:- (1) The Board shall maintain

cash register, assets register and all the books of accounts.

(2) The Board shall maintain required books of accounts for the purpose

specified in rules 20 and 21.

(3) The Board shall maintain all the database of registration and claims in

electronic format securely.

(4) The Board may maintain such records and registers as it considers

necessary.

(5) The Registering Authority and Claims Authority shall maintain all the

records submitted by applicant or Cine and Cultural activists and

produce those records whenever required by higher authority.

******

43

FORM –I

[See sub-rule (1) ofrule7]

THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD

Application for registration with “Karnataka Cine and Cultural Activists Welfare Board.

To,

Registering Officer

01

Name as Per Aadhaar:

02

Father/Spouse Name:

03

Permanent Address:

__________________Taluk_____________

District____________State___________

PIN___________

03(A)

Assembly Constituency

04

Present Address

__________________Taluk_____________Distri

ct____________State___________

PIN___________

05

UAN No. (e-Shram

registration No.)

05(A)

Aadhaar No.

05(B)

Ration Card Type and No.

APL/BPL and No.

06

Gender

Male/Female/Transgender

07

Date of Birth

DD/MM/YYY

08

Religion

Hindu/Muslim/Christian/Other

08(A)

Caste

SC/ST/OBC/Gen

10

Educational Qualification

Illiterate/Primary

School/Secondary

School/10th/12th/ITI/Diploma/Degree/P

ost Graduate

11

Nature of Work

As per List identified by the Board.

12

Experience in Work at the

time of registration

Year and Month

13

Working with The Cine

and

Cultural

Activist/

Organization

Yes/No

13(A)

If Yes

a) Name of the The Cine and Cultural

Activist

b)Address with contact No.

c)Daily Wage.

d)Monthly Wage.

14

Nominee Details

Sl. No:

Name:

Gender:

Relation:

Father/Mother/Spouse/Son/Daughter.

Age:

Marital Status:

15

Aadhaar Linked Bank

Account No.

44

I hereby declare that all the above information and documents submitted are true

and collect to the best of my knowledge and belief. I also realize that it is an offence

to furnish false information to a public authority and that if any information is found

false, I may be prosecuted for the same.

Place:

Date:

Signature/LTI of Applicant

Documents to be upload:

 Photo

 Employee ID/Employment Certificate (If working in an organisation).

Acknowledgment

Smt./Mr.……………………………

Application

No.

……………………………

Date:…………………… an application has been submitted for registration with

“Karnataka Cine and Cultural Activists’ Welfare Board. The application and

supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer

Sanction/Rejection Order

The Application No.………………Date……………… registration with “Karnataka

Cine and Cultural Activists’ Welfare Board and documents are satisfactory. So,

I registered the Cine and Cultural Activists with “Karnataka Cine and Cultural

Activists’ Welfare Board.

Place :

Date : Signature of the registration authority

…………………………………………………………………………………………………………

………………………………………………………………………………………………………

45

For

the

following

reasons

I

have

rejected

the

application

No.:………………………………

Date:…………………………

for

registration

with

“Karnataka Cine and Cultural Activists’ Welfare Board.

1.

2.

3.

Place :

Date : Signature of the registration authority

FORM –II

[See sub-rule (1) of rule 7]

THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD

Employment Certificate

Shri/Smt./Kum__________________________C/o___________________ residing

at

_________________________________________________,

is

working

as

_____________________________ in our organisation since___________ months

__________years. He/She is receiving Rs._________as daily/monthly wages.

Our Organisation details are as follows:

1. Name

of

Organisation/The

Cine

and

Cultural

Activist:__________________________________

2. Address of Organisation/The Cine and Cultural Activist: ________________________

_____________________________________________________________

3. Name and Phone/Mobile No of Contact person:______________________

4. Employee

ID

(If

available)

and

Date

of

Joining

our

organisation:____________________________

Place:

Date:

Signature and seal of the Cine and Cultural Activist/organisation

46

FORM –III

[See sub-rule (3)of rule7]

THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD

Application for renewal of registration with “Karnataka Cine and Cultural Activists

Welfare Board.

To,

Registering Officer

Tick Which is to be updated in registration details

01

Registration No.

and Date of

registration

02

Previous

registering officer

details

01

Name as Per

Aadhaar:

02

Father/Spouse

Name:

03

Permanent

Address:

__________________Taluk__________

___District____________State______

_____ PIN___________

03(A)

Assembly

Constituency

04

Present Address

__________________Taluk__________

___District____________State______

_____ PIN___________

05

UAN No. (eShram

registration No.)

Can not

changed

05(A)

Aadhaar No.

Can not

changed

05(B)

Ration Card Type

and No.

APL/BPL and No.

06

Gender

Can not

changed

Male/Female/Transgender

07

Date of Birth

Can not

changed

DD/MM/YYY

08

Religion

Can not

changed

Hindu/Muslim/Christian/Other

08(A)

Caste

Can not

changed

SC/ST/OBC/Gen

09

Educational

Qualification

Illiterate/Primary

School/Secondary

School/10th/12th/ITI/Diploma/D

egree/Post Graduate

10

Nature of Work

As per List identified by the Board.

11

Experience in

Work at the time

of registration

Year and Month

47

12

Working with The

Cine and

Cultural

Activist/Organisa

tion

Yes/No

12(A)

If Yes

a) Name of the The Cine and

Cultural Activist

b)Address with contact No.

c)Daily Wage.

d)Monthly Wage.

13

Nominee Details

Sl.No:

Name:

Gender:

Relation:

Father/Mother/Spouse/Son/Dau

ghter.

Age:

Marital Status:

14

Aadhaar Linked

Bank Account

No.

I hereby declare that all the above information and documents submitted are true

and collect to the best of my knowledge and belief. I also realise that it is an offence

to furnish false information to a public authority and that if any information is

found false, I may be prosecuted for the same.

Place:

Date:

Signature/LTI of Applicant

Documents to be upload:

 Photo

 Employee ID/Employment Certificate (If working in an organisation).

Acknowledgment

Smt./Mr.……………………………

Application

No.

……………………………

Date:…………………… an application has been submitted for renewal of

registration with “Karnataka Cine and Cultural Activists Welfare Board. The

application and supporting documents are subject to verification.

Place :

Date : Signature and seal of the officer

48

Sanction/Rejection Order

The Application No.………………Date……………… renewal of registration with

“Karnataka Cine and Cultural Activists Welfare Board” and documents are

satisfactory. So, I re-registered the Cine and Cultural Activists with

“Karnataka Cine and Cultural Activists Welfare Board.

Place :

Date : Signature of the registration authority

…………………………………………………………………………………………………………

………………………………………………………………………………………………………F

or

the

following

reasons

I

have

rejected

the

application

No.:……………………………… Date:………………………… for renewal of registration

with “Karnataka Cine and Cultural Activists Welfare Board.

1.

2.

3.

Place :

Date : Signature of the registration authority

49

FORM –IV

[See sub-rule (6) of rule7]

THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD

Identity Card

Govt. of Karnataka

: Department of Labour

Karnataka Cine and Cultural Activists Welfare Board, Bengaluru

Identity card

Registration No.

with date of

registration and

expiry

:

Name

:

Father/Spouse

Name

:

Gender

:

Date of Birth

:

Occupation

Address

:

Mobile No.

:

Workers signature /LTI

Registration authority signature

Photo

Terms and Conditions

Contact Details

50

FORM –V

[See sub-rule (3) of rule 12]

THE KARNATAKA CINE AND CULTURAL ACTIVISTS WELFARE BOARD

Application for Accidental Death Claim to Registered Cine and Cultural Activists

Application No:

To,

Claim Authority,

Applicant's/Nominee Personal Details:

1. Name as per Aadhar

2. Date Of Birth & Age

3. Aadhar Number

4. Relationship with

Registered Cine and

Cultural Activists

5. Address

Permanent

Present

6. Mobile Number

7. Date of accident.

8. Date of Death

Registration Details of Cine and Cultural Activists:

1. Name

2. Registration Number:

3. Father/Spouse Name

4. Date Of Birth & Age:

5. Occupation:

Bank

Details

of

Applicant/Nominee

 Bank Name

 Branch Name

 Aadhaar linked Account

Number

 IFSC Code

List of Documents

Submitted:(All Attested copy’s)

Yes/No

Registered

Workers

Photo (if

available)

Applicant/

Nominee

Photo

51

1. Original registration Identity

Card of Cine and Cultural

Activists

2. Employment Certificate

3. FIR copy (Attested by

respected Police Station).

4. Post Mortem report (Attested

by respected Police station or

Hospital)

5. Death Certificate of Cine and

Cultural Activists

6. Aadhar card copy of

Applicant/Nominee and

deceased

7. Ration card (If available)

8. Living Member Certificate of

deceased (Issued by Revenue

Department)

9. Copy of Applicant/Nominee

Aadhaar linked bank

passbook

I hereby declared that the details furnished above are true and correct to

the best of my knowledge. In case any of above information is found to be false or

untrue. I am aware that I may be held liable for it.

Place :

Date : Signature/Thumb impression of the Nominee