RECOMMENDATION BY BDO CONCERNED.

____________________________________________________________

____________________________________________________________

____________________________________________________________

Seal & Sig of BDO

RECOMMENDATION BY TSO CONCERNED.

____________________________________________________________

____________________________________________________________

____________________________________________________________

Seal & Sig of TSO

RECOMMENDATION BY TEHSILDAR CONCERNED.

____________________________________________________________

____________________________________________________________

____________________________________________________________

Seal & Sig of Tehsildar

 Application for Change in Priority

Name:- ____________________________________________________________________
Parentage:- _________________________________________________________________
Details of family members.
S. No. Name Parentage Age Sex Adhaar No.
1
2
3
4
5
6

I am resident of village _________________________ Tehsil _____________________

I have been enrolled under NFSA under Category ___________ bearing ID No. _____________.
As such I may be enrolled under NFSA under_____________________ category.
Sig. of Applicant

FCS & CA Deptt.

1. Ration card ID ________________ souls __________________

2. Existing category _____________________________________

Seal & Sig SK/CBC

Report of Village Level Committee

REVENUE

1. Family details as per CHOLA Register ________________.

2. Land ___________________________________________.
3. Income. ________________________________________.
Sig. of Patwari

RURAL DEV. Deptt.

1. Occupation.____________________________________.
2. House type. ____________________________________.
3. Latrine Type. ___________________________________.
Sig. of V.L.W