7/25/2019 Kashyapa_21307

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APPLICATION FORM

Kashyapa Scheme for Food and Shelter

Andhra Pradesh Brahmin Welfare Corporation Ltd.,

(A Govt. of A.P., Undertaking)

Regd.No: KS-FS-21307

Sect

Gothram

Sur Name

Applicant Name

Gender

Date of Birth

Languages Known

Type of disability

% of disability

Status of Parents

:

:

:

:

:

:

:

:

:

:

-NA-

Koundinyasa

DHARMAVARAM

SUDHAKARA RAO

21/08/1951

NA

Profession

Annual Income

Ration Card No

AADHAAR No

Present Address

Street Name

Land mark

Village

Mandal

District

STD & Land Line

Mobile No

e-Mail ID

W/o SAVITHRIGuardian

HOUSE WIFE

24,000

RAP106101301734

379621188715

:

:

:

:

:

:

:

Door No

:

:

:

:

6-57

ACHARYA STREET

BAZAR STREET

BAIREDDIPALLE

BAIREDDIPALLI

9490504084

vaiswanara@gmail.com

Telugu

:

:

CHITTOOR, PIN Code : 517415

:

Bank details:

IFS CODE

Branch Name

Student's SB A/c No.

:

:

: 181810100117617

PALAMANERU

ANDB0001818

Bank Name : ANDHRA BANK

Permanent Address

Male

Kashyapa Scheme for Elder - staying on his / her own

21/06/2016