OFFICE OF THE DEPUTY COMMISSIONER

ONLINE APPLICATION FORM FOR ISSUING OF PERMANENT / TEMPERORY RESIDENTIAL CERTIFICATE

Guideline for filling the form

Application Form

Applying For * Please select appropriate application type

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Applicant Details

Salutation *

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Full Name of applicant / आवेदक का पूरा नाम *

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Salutation *

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Father's Name / पिता का पूरा नाम Please enter applicant father name

Applicant Photograph

Husband's Name

Applicant Mobile No May provide Mobile no for future communication

Applicant E-Mail May provide e-Mail ID for future communication

Address Details of Applicant

Name & Present Address of applicant / Person under whom applicant is working

Care of * If you applying for TRC (General) than care of treat as TRC(General) otherwise it will treat as TRC(Business).

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Designation

Department

Village

Post Office

Police Station

District

Permanent Address Details of Applicant

Address Line 1 * (eg: House No., Flat No., Building No., Plot No., Lift No. .....)

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Address Line 2 (eg: Building Name, Block Name/No., Street Name/No., Mohalla, Sector No., Sector Name .....)

Circle *

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Country *

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State *

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District

Postal / Zip Code

Post Office *

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Police Station *

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Village *

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Information Required for Temporary Residency Certificate

Relationship with the Applicant (Other than own children, submit documentary evidence of guardian ship/dependent certificate etc.)

Year since the applicant whom certificate is required has been residing at *

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Place of Birth with State

Birth Place

State

Reason for which certificate is required

Trading / Hawkers License No.

Information Required for Permanent Residency Certificate

Nos of year (s) of Residence Years Eg : 15 years

Tribe

Age

Purpose for which PRC is required

Reference of ST Certificate

Memo No.(In case of married women PRC or STC of her husband must be enclosed)

Dated (memo No) :

Is Surrender / Duplicate case ?

Yes

Original PRC No.

Dated :

Land passbook No. (in case of Pasighat Urban area)

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I hereby declare that

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i) Whatever I have stated in this application is true the best of my knowledge and belief.

ii) I shall be punishable in the event of finding any above particulars false, even in future.

Yes