2
ॢबहर गजट
[सधरण 2 जनवर 2017
[kk| ,oa miHkksDrk laj{k.k
foHkkxA
@¼iii½ jk'ku dkMZ dk
izR;iZu@ jn~nhdj.k
vuqeaMy
inkf/kdkjh
30 dk;Z
fnol
ftyk
inkf/kdkjh
21 dk;Z
fnol
ize.Myh;
vk;qDr
15 dk;Z
fnol
**
2-
mi;qZDr vf/klwpuk ds ifjf’k"V&I ds ckn fuEufyf[kr ifjf’k"V&II tksM+k tk,xk%&
^^ifjf’k"V&II
lsok izkIr djus gsrq vkosnu ds lkFk tek fd, tkus okys vko';d dkxtkr ¼psd fyLV½
lsok dk uke
psd fyLV
1- u;s jk'ku dkMZ dk fuxZeu
1- vkosnu i= foHkkxh; izi= ^d* esa A
2- vk/kkj dkMZ dk Nk;kizfr A
3- cSad [kkrk ds izFke i`"B dh Nk;kizfr] ftlij [kkrk/kkjh dk uke] [kkrk
la[;k] cSad dk uke] cSad dk IFSC Code jgrk gS A
4- vkoklh; izek.k&i=
5- foHkkxh; vkosnu i= izi= ^d* ds Øekad 10 vFkok 11 tks ykxw gks] ds
laca/k esa 'kiFk&i=A
6- lEiw.kZ ifjokj dk rhu QksVksxzkQ A
2- jk'ku dkMZ esa la'kks/ku ¼uke esa
la'kks/ku] uke tksM+uk] uke gVuk½
1- vkosnu i= foHkkxh; izi= ^[k* esa A
2- O;fDr] ftldk uke tksM+k tkuk gS] ds vk/kkj dkMZ dh Nk;k izfrA
3- foHkkxh; vkosnu izi= ^[k* ds Øekad 8 ,oa 9 ds laca/k esa ykxw dkj.k ds
izek.k&i= dh Nk;kizfr] ;Fkk %&
i. fuokl esa ifjorZu gsrq vkoklh; izek.k&i=
ii. tUe@e`R;q dk izek.k i=
iii. jk'ku dkMZ esa of.kZr v'kqf);k¡ ftudks 'kq) fd;k tkuk gS] ds fy,
ljdkjh izek.k&i= ¼ljdkjh fo|ky; dk izek.k&i=] vk/kkj dkMZ]
oksVj vkbZ0dkMZ] MªkbZfoax ykbZlsal] iSu dkMZ vkfn½A
3-
jk'ku
dkMZ
dk
izR;iZ.k
(Surrender)@jn~nhdj.k
1- vkosnu i= foHkkxh; izi= ^[k* esa A
2- fo|eku jk'ku dkMZ dk izR;Zi.k@jn~n djus ds fy, vkosnu i= ds
Øekad 10 ds laca/k esa ykxw dkj.k dh Nk;kizfr A
lkekU; funsZ'k
1- vkosnu&i= dsoy ,d gh izfr vkosnd }kjk Hkjh tk;sxh A
2- fdlh O;fDr] laxBu ;k jktuhfrd ikVhZ }kjk rknkn esa izLrqr fd;s x;s vkosnu&i=ksa dks Lohdkj ugha
fd;s tk,saxs A
3- viw.kZ vkosnu i= dks jn~n dj fn;k tk;sxk A
4- vgLrk{kfjr ;k fcuk vaxwBs ds fu'kku ds vkosnu&i= dks jn~n dj fn;k tk;sxk A
5- gLrfyf[kr] VkbZi fd;s x;s] QksVks dkWih fd;s x;s ;k ,u-vkbZ-lh- dh csclkbZV ls MkmuyksM fd;s x;s
izi= Hkh Lohdkj fd;s tk;saxs] c'krsZa fd bl izdkj ds izi= fu/kkZfjr izi= ds le:i gksus pkfg, A
6- lHkh vkosnu i= RTPSds ek/;e ls fy;s tk;sxsa A
7- ljdkjh lsok ls rkRi;Z gS dsUnz ,oa jkT; ljdkj] yksd miØe] LFkkuh; fudk; ,oa Lo'kklh esa fu;fer
osrueku esa dk;Zjr dehZ dh lsok A
8- RTPSds rgr ik= x`gLFkh }kjk jk'ku dkMZ dk vkosnu&i= lacaf/kr {ks= ds vuqeaMy inkf/kdkjh ds
dk;kZy; esa tek fd;k tk;sxk A
9- vuqeaMy inkf/kdkjh }kjk RTPSds rgr jk'ku dkMZ gsrq izkIr vkosnu&i= dks ,d lIrkg ds vUnj
lacaf/kr {ks= ds iz[kaM fodkl inkf/kdkjh dks Hkstk tk;sxk A iz[kaM fodkl inkf/kdkjh }kjk izkIr vkosnu
i= dks tkap djkdj 15 fnuksa ds vUnj vuqeaMy inkf/kdkjh dks okil fd;k tk;sxk A
10- vuqeaMy inkf/kdkjh }kjk vkosnu&i= dks Lohd`r fd;k tkrk gS rks jk'ku dkMZ fuxZr fd;k tk;sxkA
3
ॢबहर गजट
[सधरण 2 जनवर 2017
izi= ^d*
yksd lsok ds vf/kdkj vf/kfu;e ds vUrxZr u;k jk'ku dkMZ ds fy, vkosnu i=
¼jk"Vªh; [kk| lqj{kk vf/kfu;e 2013 ¼/kkjk&9½ rFkk yf{kr lkoZtfud forj.k iz.kkyh ¼fu;a=.k½
vkns'k 2015 ¼dafMdk 3 dk midafMdk 13] 14 rFkk dafMdk 4 midafMdk 7] 8] 9 nz"VO;½
1- vkosnd dk uke
2- vk/kkj@ EID no
3- eksckbZy ua0&
4- vkosnd ds ifr@firk dk uke
5- iw.kZ vkoklh; irk
6- cSad dk IFSC Code
7- cSad [kkrk ua0
8- cSad rFkk 'kk[kk dk uke
9- jk'ku dkMZ ds fy, ifjokj ds vU; lnL;ksa dk fooj.k
Ø0
uke
ifr@firk dk
uke
fyax
mez
oSokfgd
fLFkfr
laca/k
1
2
3
4
5
6
7
ikfjokfjd QksVks
4
ॢबहर गजट
[सधरण 2 जनवर 2017
vk/kkj@ EID no
eksckbZy ua0 O;olk;@lsok vkenuh dk lzksr
ekfld vk;
8
9
10
11
12
10-xzkeh.k {ks= ds vkosnd fuEufyf[kr ij gkW@ugha] ij fVd yxkos %&
(i)
eksVj pkfyr frikfg;k@pkj ifg;k okgu gS] gkW ugha
(ii) e'khu pkfyr rhu@pkj ifg;ksa okys d`f"k midj.k gS] gkW ugha
(iii) ljdkj esa iathd`r xSj&d`f"k m|ksx okys ifjokj okyh x`gLFkh gS] gkW ugha
(iv) ifjokj ds fdlh lnL; dh ekfld vk; 10]000@&:0 ls vf/kd gS] gkW ugha
(v) vk;dj nsrs gS] gkW ugha
(vi) O;kolkf;d dj dk Hkqxrku djrs gS] gkW ugha
(vii) ftl edku esa jgrs gS] ml edku esa lHkh dejksa esa iDdh nhokjksa vkSj Nr ds lkFk
rhu vFkok vf/kd dejk gS] gkW ugha
(viii) ifjokj esa de ls de ,d flapkbZ midj.k ds lkFk 2-5 ,dM+ vFkok blls vf/kd
flafpr Hkwfe gS] gkW ugha
(ix) nks vFkok mlls vf/kd Qlyh ekSle ds fy, 5 ,dM+ vFkok blls vf/kd flafpr
Hkwfe okyh x`gLFkh gS] gkW ugha
(x) de ls de ,d flapkbZ midj.k ds lkFk de ls de 7-5 ,dM+ vFkok blls
vf/kd Hkwfe okyh x`gLFkh gS] gkW ugha
(xi) vkosnd vFkok vkosnd ds ifjokj dk dksbZ lnL; ljdkjh lsok esa gS]
gkW ugha
vxj gS rks mldk fooj.k &
¼d½ fdl lsok esa gS &
¼[k½ dgkW inLFkkfir gS &
¼x½ fdruk ekfld vkenuh gS &
5
ॢबहर गजट
[सधरण 2 जनवर 2017
11- 'kgjh {ks= ds vkosnd fuEufyf[kr ij vko';drkuqlkj gkW@ugha] ij fVd yxkos %&
(i)
vk;dj vnk djrs gS] gkW ugha
(ii) vkosnd vFkok vkosnd ds ifjokj dk dksbZ lnL; oxZ d] oxZ [k] oxZ x ,oa oxZ
?k Js.kh ds ljdkjh lsok ¼vuq0tkfr@vuq0 tutkfr ds lewg ^?k* ds dehZ dks
NksM+dj½ esa gS] gkW ugha
vxj gS rks mldk fooj.k &
¼d½ fdl lsok esa gS &
¼[k½ dgkW inLFkkfir gS &
¼x½ fdruk ekfld vkenuh gS &
(iii) O;olkf;d dj vnk djrs gS] gkW ugha
(iv) rhu dejs ;k mlls vf/kd ¼iDdk½ daØhV Nr;qDr edku okyh x`gLFkh tks Lo;a
dh LokfeRo esa gS] gkW ugha
(v) ifjokj ds fdlh lnL; dk ekfld vk; 20]000@&:0 ls vf/kd gS] gkW ugha
(vi) nks ifg;k okgu] jsQzhtjsVj rFkk okf'kax e'khu rhuksa midj.k gS] gkW ugha
(vii) x`gLFkh esa pkj ifg;k okgu gS] gkW ugha
(viii) x`gLFkh esa okf'kax e'khu gS] gkW ugha
fnukad
vkosnd dk gLrk{kj@vaxwBs dk fu'kku
LFkku
uke
?kks"k.kk
egksn;k@egksn;
eSa ifjokj lfgr ;g ?kks"k.kk djrk gwWw fd vkosnu i= esa fy[kh xbZ lHkh izfof"V;kW lgh gSaA
eSaus blds iwoZ jk'ku dkMZ ds fy, dksbZ vkosnu i= ugha fn;k gSA vxj vkosnu&i= esa fyf[kr
dksbZ rF; xyr ik;k tkrk gS] rks eSa naMkRed@dkuwuh dkjZokbZ dk Hkkxh gksšxk A
fnukad
vkosnd dk gLrk{kj@vaxwBs dk fu'kku
LFkku
uke
iwfoZdrkizkIr x`gLFkh ds vUrxZr %&
vkosnu i= & Lohd`r vLohd`r
vLohd`r dk dkj.k &
6
ॢबहर गजट
[सधरण 2 जनवर 2017
izi= ^[k*
yksd lsok ds vf/kdkj vf/kfu;e ds vUrxZr fo|eku jk'ku dkMZ esa mikarj.kks
vFkok fo|eku jk'ku dkMZ dks izR;iZ.k ¼Surrender)/ jn~n djus ds fy,
¼jk"Vªh; [kk| lqj{kk vf/kfu;e 2013 ¼/kkjk&9½ rFkk yf{;r lkoZtfud forj.k iz.kkyh ¼fu;a=.k½ vkns'k 2015
¼jk"Vªh; [kk| lqj{kk vf/kfu;e 2013 ¼/kkjk&9½ rFkk yf{;r lkoZtfud forj.k iz.kkyh ¼fu;a=.k½ vkns'k 2015
¼jk"Vªh; [kk| lqj{kk vf/kfu;e 2013 ¼/kkjk&9½ rFkk yf{;r lkoZtfud forj.k iz.kkyh ¼fu;a=.k½ vkns'k 2015
¼jk"Vªh; [kk| lqj{kk vf/kfu;e 2013 ¼/kkjk&9½ rFkk yf{;r lkoZtfud forj.k iz.kkyh ¼fu;a=.k½ vkns'k 2015
¼dafMdk 3 dk
¼dafMdk 3 dk
¼dafMdk 3 dk
¼dafMdk 3 dk midafMdk 13] 14 rFkk dafMdk 4 midafMdk 7] 8] 9½ nz"VO;½
midafMdk 13] 14 rFkk dafMdk 4 midafMdk 7] 8] 9½ nz"VO;½
midafMdk 13] 14 rFkk dafMdk 4 midafMdk 7] 8] 9½ nz"VO;½
midafMdk 13] 14 rFkk dafMdk 4 midafMdk 7] 8] 9½ nz"VO;½
1-
vkosnd dk uke
2-
vk/kkj@ EID no
3-
eksckbZy ua0&
4-
vkosnd ds ifr@firk dk uke
5-
iw.kZ vkoklh; irk
6-
fo|eku jk'ku dkMZ dh la0&
7-
lEc) tu forj.k iz.kkyh foØsrk dk uke ,oa vuqKfIr la0&
8-
fo|eku jk'ku dkMZ esa mikarj.k dk dkj.k&
¼d½ fuokl esa ifjorZu &
¼[k½ tUe ;k e`R;q &
¼x½ dkMZ esa of.kZr C;ksjks esa v'kqf);kW &
¼?k½ vU; dkj.k &
9-
fo|eku jk'ku dkMZ esa mikarj.k gsrq fooj.kh &
Ø0
uke
ifr@firk dk
uke
fyax
mez
oSokfgd
fLFkfr
laca/k
1
2
3
4
5
6
7
ikfjokfjd QksVks
7
ॢबहर गजट
[सधरण 2 जनवर 2017
10- fo|eku jk'ku dkMZ dks izR;iZ.k@jn~n djus dk dkj.k &
¼d½ xzkeh.k {ks= esa izokl] tUe] fookg] lkekftd vkSj vkfFkZd ifjfLFkfr esa
ifjorZu ds dkj.k vkosnd fuEufyf[kr ij gkW@ugha] ij fVd yxkos %&
(i)
eksVj pkfyr frikfg;k@pkj ifg;k okgu gS] gkW ugha
(ii)
e'khu pkfyr rhu@pkj ifg;ksa okys d`f"k midj.k gS] gkW ugha
(iii) ljdkj esa iathd`r xSj&d`f"k m|ksx okys ifjokj okyh x`gLFkh gS] gkW ugha
(iv) ifjokj ds fdlh lnL; dh ekfld vk; 10]000@&:0 ls vf/kd gS]
gkW ugha
(v)
vk;dj nsrs gS] gkW ugha
(vi) O;kolkf;d dj dk Hkqxrku djrs gS] gkW ugha
(vii) ftl edku esa jgrs gS] ml edku esa lHkh dejksa esa iDdh nhokjksa vkSj Nr ds
lkFk rhu vFkok vf/kd dejk gS] gkW ugha
(viii) ifjokj esa de ls de ,d flapkbZ midj.k ds lkFk 2-5 ,dM+ vFkok blls
vf/kd flafpr Hkwfe gS] gkW ugha
(ix) nks vFkok mlls vf/kd Qlyh ekSle ds fy, 5 ,dM+ vFkok blls vf/kd
flafpr Hkwfe okyh x`gLFkh gS] gkW ugha
(x)
de ls de ,d flapkbZ midj.k ds lkFk de ls de 7-5 ,dM+ vFkok blls
vf/kd Hkwfe okyh x`gLFkh gS] gkW ugha
(xi) vkosnd vFkok vkosnd ds ifjokj dk dksbZ lnL; ljdkjh lsok esa gS]
gkW ugha
vxj gS rks mldk fooj.k &
¼d½ fdl lsok esa gS &
¼[k½ dgkW inLFkkfir gS &
¼x½ fdruk ekfld vkenuh gS &
vk/kkj@EID no
eksckbZy ua0
O;olk; @
ljdkjh lsod
vkenuh
dk lzksr
ekfld
vk;
8
9
10
11
12
8
ॢबहर गजट
[सधरण 2 जनवर 2017
¼[k½ 'kgjh {ks= esa izokl] tUe] fookg] lkekftd vkSj vkfFkZd izkfLFkfr esa ifjorZu
ds dkj.k vkosnd fuEufyf[kr ij gkW@ugha] ij fVd yxkos %&
(i)
vk;dj vnk djrs gS] gkW ugha
(ii) vkosnd vFkok vkosnd ds ifjokj dk dksbZ lnL; oxZ 1] oxZ 2] oxZ 3 ,oa oxZ
4 Js.kh ds ljdkjh lsok ¼vuq0tkfr@vuq0 tutkfr ds Group 'D' ds dehZ dks
NksM+dj½ esa gS] gkW ugha
vxj gS rks mldk fooj.k &
¼d½ fdl lsok esa gS &
¼[k½ dgkW inLFkkfir gS &
¼x½ fdruh ekfld vkenuh gS &
(iii) O;olkf;d dj vnk djrs gS] gkW ugha
(iv) rhu dejs ;k mlls vf/kd ¼iDdk½ daØhV Nr;qDr edku okyh x`gLFkh tks
Lo;a dh LokfeRo esa gS] gkW ugha
(v) ifjokj ds fdlh lnL; dk ekfld vk; 20]000@&:0 ls vf/kd gS]
gkW ugha
(vi) nks ifg;k okgu] jsQzhtjsVj rFkk okf'kax e'khu rhuksa midj.k gS] gkW ugha
(vii) x`gLFkh esa pkj ifg;k okgu gS] gkW ugha
(viii) x`gLFkh esa okf'kax e'khu gS] gkW ugha
mijksDr dafMdk --------- ds vuqlkj fo|eku jk'ku dkMZ esa vko';d
mikarj.k fd;k tk;@dafMdk ------------ ds vuqlkj ik= x`gfLFk;ksa gsrq ekud ekunaM
ls ckgj gks tkus ds dkj.k fo|eku jk'ku dkMZ dks jn~n dj fn;k tk; ¼jk'ku
dkMZ layXu½
fnukad
vkosnd dk gLrk{kj@vaxwBs dk fu'kku
LFkku
uke
?kks"k.kk
egksn;k@egksn;
eSa ifjokj lfgr ;g ?kks"k.kk djrk gwWw dh vkosnu&i= esa fy[kh xbZ lHkh izfof"V;kW lgh gSA
vxj vkosnu i= esa fyf[kr dksbZ rF; xyr ik;k tkrk gS rks eSa naMkRed@dkuwuh dkjZokbZ dk
Hkkxh gksÅWxk A
fnukad
vkosnd dk gLrk{kj@vaxwBs dk fu'kku **
LFkku
uke
3 vf/klwpuk la[;k 19431 fnukad 23-12-2013 dh 'ks"k izfof"V;k¡ iwoZr jgsaxhA
4 le;≤ ij lsok izkIr djus gsrq [kk| ,oa miHkksDrk laj{k.k foHkkx] vko';drkuqlkj
blls lacaf/kr vU; izi= fof/k foHkkx ds ijke’kZ ds Ik'pkr tkjh dj ldsxkA
fcgkj&jkT;iky ds vkns'k ls]&
n;kfu/kku ik.Ms;]
ljdkj ds vij lfpoA
9
ॢबहर गजट
[सधरण 2 जनवर 2017
30 fnlEcj 2016
laŒ 18@yks0ls0v0&12&01@2016¼[k.M½lk0iz0&17409&vf/klwpuk la[;k&17408] fnukad
30-12-2016 dk fuEufyf[kr vaxzsth vuqokn fcgkj&jkT;iky ds izkf/kdkj ls ,rn~ }kjk izdkf'kr
fd;k tkrk gS] tks Hkkjr&lafo/kku ds vuqPNsn 348 ds [k.M ¼3½ ds v/khu vaxzsth Hkk"kk esa mldk
izkf/kd`r ikB le>k tk;sxkA
fcgkj&jkT;iky ds vkns'k ls]&
n;kfu/kku ik.Ms;]
ljdkj ds vij lfpoA
———
30th December 2016
No-18/Lo.Se.A.-12-01/2016(Part)-17408—In exercise of the power conferred by the
Section-3 of Bihar Right to Public Services Act ,2011 (Bihar Act,4,2011) the State Government
makes following amendments in Notification No-19431 dated 23.12.2013 of General Administration
Department, Bihar, Patna with immediate effect :-
1. Serial No-7 of Appendix -1 of the above notification would be substituted as follows :-
“Appendix-1
Sl.
No.
Name of the
Department/Service
Namely
Specified
Public
Servant
Stipulated
Time for
Service
Appellate
Authority
Stipulated
Time for
Disposal of
First
Appeal
Reviewing
Authority
Stipulated
Time for
Disposal of
Second
Appeal
1
2
3
4
5
6
7
8
7
Food and Consumer
Department.
(i) Issuance of New
Ration Card
Sub-
Divisional
Officer
30
working
days
District
Magistrate
21 working
days
Divisional
Commissi
oner
15 working
days
Food and Consumer
Department.
(ii) Rectification of
Ration Card
(Rectification in
name /addition or
deletion of name)
Sub-
Divisional
Officer
30
working
days
District
Magistrate
21 working
days
Divisional
Commissi
oner
15 working
days
Food and Consumer
Department.
(iii) Surrender/
Cancelation of
Ration Card
Sub-
Divisional
Officer
30
working
days
District
Magistrate
21 working
days
Divisional
Commissi
oner
15 working
days
“
10
ॢबहर गजट
[सधरण 2 जनवर 2017
2. Appendix –II will be added after Appendix-I of the concerned notification:-
“Appendix-II
Documents to be submitted for the specified Service (Check List )
Name of Service
Check List
1.
Issuance
of
New
Ration Card
1. Application in Department's Pro-forma 'k'
2. Photo Copy of Adhar Card
3. Photo Copy of the First Page of Bank Account which
reflects Name, Account Number , Name of Account
Holder , IFSC Code of Bank
4. Residential Certificate
5. Affidavit regarding Serial No. 10 or 11 (whichever is
applicable) of Department's Pro-forma 'K'
6. Three Group Photographs of the whole family
2. Rectification in Ration
Card (Rectification
in Name, Addition /
deletion of Name)
1. Application in Department's Pro-forma 'kh'
2. Photo Copy of Adhar Card of Person whose Name is
applied for addition
3. Photo Copies of Certificates of valid ground regarding
Serial No. 8 & 9 of Department's Pro-forma 'kh' e.g.
i. Certificate required for residential change
ii. Birth or death Certificate
iii. Government Certificate–Certificate given by
Government School, Adhar Card, Voter ID,
Driving License, PAN Card etc. in respect of
the errors required to be corrected
3. Surrender/ Cancelation
of Ration Card
1. Application in Department's Pro-forma 'kh'
2. Photo copy of valid reason for Surrender /Cancelation of
Ration Card required in respect of the Serial No. 10 of
Application Form
General Instructions
1. Only one copy of duly filled application should be submitted.
2. Numerous applications submitted by any Person, Organisation or Political Party will not be
accepted.
3. Incomplete application will be rejected.
4. Unsigned or application without thumb impression will be rejected.
5. Hand written, typed copy, photo copy or pro-forma downloaded from NIC website will also
be accepted, subject to its uniformity with the prescribed pro-forma.
6. All applications will be accepted through RTPS.
7. Government Service means service of personnel serving under Central / State Government
in regular pay scale or in Public Enterprises, Local Bodies and Autonomous Organisations /
Bodies.
8. Application of Ration Card under RTPS of eligible house-hold will be submitted at the Sub-
divisional office of the concerned region.
9. Received applications will be forwarded by the Sub-Divisional Officer to the concerned
Block Development Officer through RTPS within one week. After making essential
verification Block Development Officer will revert applications to the concerned Sub-
divisional Officer within 15 days.
10. Ration Card will be issued after approval of the concerned Sub-Divisional Officer.
11
ॢबहर गजट
[सधरण 2 जनवर 2017
APPLICATION PRO-FORMA- 'K'
(Pro-forma for new Ration Card under Bihar Right to Public Services Act)
{See Section 9 of National Food Security Act, 2013 and Sub Para -13, 14 of Para-3 and Sub Para-7, 8,
9 of Para-4 of Targeted Public Distribution System (Control) Order, 2015}
Family Photo
1. Name of Applicant
2. Adhar/EID Number
3. Mobile Number
4. Father's/Husband's Name of Applicant
5. Full Residential Address
6. IFSC Code of Bank
7. Bank's Account Number
8. Name of Bank & Branch
9. List of other family members for Ration Card
Sl.
No.
Name
Father's /Husband's
Name
Gender
Age
Marital
Status
Relation
1
2
3
4
5
6
7
Adhar/EID
No.
Mobile No.
Occupation / Service
Source of
Income
Monthly Income
8
9
10
11
12
10.
Applicant of Rural Area will tick either Yes /No of the followings:-
(i)
Whether owns motor driven tricycle / four wheeler Yes No
(ii)
Whether owns machine driven three/four wheeled agriculture equipments
Yes No
(iii) Whether holds non-agriculture professional family house-hold registered
under the government Yes
No
(vi) Whether monthly income of any member of family is more than Rs. 10,000/-
Yes
No
(v)
Whether pays Income Tax Yes No
(vi) Whether pays professional tax Yes No
(vii) Whether all rooms (either three or more) of house in which he/she lives is
made up of cemented walls and roof Yes No
(viii) Whether family holds at least one agriculture equipment with 2.5 or more
acres of irrigated land Yes No
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ॢबहर गजट
[सधरण 2 जनवर 2017
(ix) Whether holds house-hold with five or more acres of irrigated land for two or
more crop seasons Yes No
(x) Whether holds house-hold having one agriculture equipment at least with 7.5
or more acres of land Yes No
(xi) Whether applicant or any member of family is in service Yes No
If Yes, give following details:-
(a) Name of Service-
(b) Place of posting –
(c) Monthly income-
11.
Applicant of Urban Area will tick either Yes /No of the followings:-
(i)
Whether pays Income Tax Yes No
(ii)
Whether applicant of any member of his/her family is in Group A, Group
B, Group C and Group D (excluding group D member of Schedule Caste
/Schedule Tribes ) service- Yes No
If Yes, give following description:-
(a) Name of Service-
(b) Place of posting –
(c) Monthly income-
(iii) Whether pays professional tax
Yes No
(iv) Whether holds self owned house-hold having a building of three or more
cemented rooms with concrete roof Yes No
(v) Whether monthly Income of any member of family is more than Rs. 20,000/-
Yes No
(v) Whether all the three equipments- Two Wheeler, Refrigerator and
Washing Machine are available Yes No
(vi) Whether house-hold has Four Wheeler Yes No
(vii) Whether house-hold has Washing Machine Yes No
Signature/Thumb Impression of Applicant
Date
Name-
Place
Declaration
Madam / Sir
I along with my family declare that entries of application are true. I
have not submitted application for Ration Card earlier. If any fact mentioned in application
is found untrue, I will be responsible to face penal/legal action.
Signature/Thumb Impression of Applicant
Date
Name-
Place
Under Priority House Hold (PHH):-
Application form – Accepted Rejected
Reason of rejection -
13
ॢबहर गजट
[सधरण 2 जनवर 2017
APPLICATION PRO-FORMA- 'KH'
(Pro-forma for rectification in Ration Card or for surrendering/ cancelation of Ration Card under
Bihar Right to Public Services Act)
{See Section 9 of National Food Security Act, 2013 and Sub Para -13, 14 of Para-3 and Sub Para-7, 8,
9 of Para-4 of Targeted Public Distribution System (Control) Order, 2015}
Family Photo
1. Name of Applicant
2. Adhar/EID Number
3. Mobile Number
4. Father's/Husband's Name of Applicant
5. Full Residential Address
6. Ration Card No.
7. Name of concerned dealer and license No.
8. Reason of rectification in Ration Card-
(a) Change of residence
(b) Birth / Death
(c) Factual errors of Ration Card
(d) Other reason
9. Description for rectification
Sl.
No.
Name
Father's /Husband's
Name
Gender
Age
Marital
Status
Relation
1
2
3
4
5
6
7
Adhar/EID
No.
Mobile No.
Occupation / Service
Source of Income
Monthly Income
8
9
10
11
12
10. Grounds for surrender / Cancelation
(A) Tick ( ) either Yes or No, in case of change in Residential, Birth, Marital, Social and
Economical change of rural area-
(i) Whether owns motor driven tricycle / four wheeler Yes No
(ii) Whether
owns
machine
driven
three/four
wheeled
agriculture
equipments
Yes No
14
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(iii) Whether holds non-agriculture professional family house-hold registered under the
government Yes No
(vi) Whether monthly income of any member of family is more than Rs. 10,000/-
Yes
No
(v) Whether pays Income Tax Yes No
(vi) Whether pays professional tax Yes No
(vii) Whether all rooms (either three or more) of house in which he/she lives is made up of
cemented walls and roof Yes No
(viii) Whether family holds at least one agriculture equipment with 2.5 or more acres of
irrigated land Yes No
(ix) Whether holds house-hold with five or more acres of irrigated land for two or more
crop seasons Yes No
(x) Whether holds house-hold having one agriculture equipment at least with 7.5 or more
acres of land Yes No
(xi) Whether applicant or any member of family is in service Yes No
If Yes, give following details:-
(d) Name of Service-
(e) Place of posting –
(f) Monthly income-
(B) Tick ( ) either Yes or No, in case of change in Residential, Birth, Marital, Social and
Economical change of urban area-
(i)
Whether pays Income Tax Yes No
(ii)
Whether applicant of any member of his/her family is in Group A, Group B,
Group C and Group D (excluding group D member of Schedule Caste
/Schedule Tribes) service- Yes No
If Yes, give following description:-
(a) Name of Service-
(b) Place of posting –
(c) Monthly income-
(iii)
Whether pays professional tax Yes No
(iv)
Whether holds self owned house-hold having a building of three or more cemented
rooms with concrete roof Yes No
(v)
Whether monthly Income of any member of family is more than Rs. 20,000/-
Yes No
(vi)
Whether all the three equipments- Two Wheeler, Refrigerator and Washing
Machine are available Yes No
(vii) Whether house-hold has Four Wheeler Yes No
(viii) Whether house-hold has Washing Machine Yes No
Kindly rectify the Ration Card according to Para----------- above / cancel the
Ration Card according to Para- ------- above.
Signature /Thumb Impression of Applicant
Date
Name-
Place
15
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[सधरण 2 जनवर 2017
Declaration
Madam / Sir
I along with my family declare that entries of application are true. If
any fact mentioned in application is found untrue, I will be responsible to face penal/legal
action.
Signature /Thumb Impression of Applicant “
Date
Name-
Place
3. Other entries of Department's notification No. 19431 dated 23-12-2013 will
remain as earlier.
4. Department of Food and Consumer Protection, Bihar, Patna will issue other
required formats, time to time, after consulatation with the Law Department.
By the order of Governor of Bihar,
DAYANIDHAN PANDEY,
Additional Secretary to Government.
————
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