2/12/25, 2:09 PM about:blank
AADHAAR ENROLMENT
FORM
(Aadhaar Enrolment is free &
भारतीय विशिष्ट पहचान प्राधिकरण भारत सरकार
Voluntary)
Under Section 3 of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND OTHER SUBSIDIES, BENEFITS AND
SERVICES) ACT,2016 (Aadhaar Act)
Submission Date : 12-02-2025 Application Type : Enrolment
Applicant Details Appointment Details
Resident Type: RESIDENT
Full Name: PARVEEN AWAIS ANSARI
Date Of 24-06-2000
Birth/Age:
Address 82/ 99/ lower depo pada parksite colony,
vikhroli parksite, sagar nagar, Mumbai,
Vikhroli, Mumbai Suburban , Maharashtra,
400079
Email
[email protected] Guardian Name: Awais Noorul Hasan Ansari
Guardian 791547523594 Appointment Id: 1739349493054
Aadhaar: Aadhaar Seva G-06,1 Aerocity, Ground floor,
Gender: Female Kendra Address: Sakinaka, Safedpul, Andheri-
Documents to Carry: Kurla Road, Mumbai-400072
Appointment Date
14-02-2025 (16:30)
and Time:
Bring original documents for Enrolment/Update.
No photocopy required.
Original documents are scanned and given back
to you.
Carry/Bring appointment print copy.
Proof of date of birth:
Birth Certificate issued by Authorized Authority (in the
respective States) under the Registration of Births and Deaths
Act, 1969 read with Registration of Births and Deaths Rules
1999/2000/2002 of respective States
Proof of relation: Indian Passport
I hereby confirm the identity and address of (HOF/Relative Name) (auto populates) as being true, correct
and accurate.
HOF s Name: Signature of HOF
Disclosure under section 3(2) of THE AADHAAR (TARGETED DELIVERY OF FINANCIAL AND
OTHER SUBSIDIES, BENEFITS AND SERVICES) ACT, 2016
I confirm that I have been residing in India for at least 182 days in the preceding 12 months / I am Non Resident Indian (NRI) &
information (including biometrics) provided by me to the UIDAI is my own and is true, correct and accurate. I am aware that my
information including biometrics will be used for generation of Aadhaar and authentication. I understand that my identity
information (except core biometric) may be provided to an agency only with my consent during authentication or as per the
provisions of the Aadhaar Act. I have a right to access my identity information (except core biometrics) following the procedure laid
down by UIDAI.
Verifier's Stamp and Signature Applicant's Signature/Thumbprint
(Verifier must put her/his name if stamp is not avaliable.)
Note: In case of Child(< 5 Yrs) or Guardian based application, Guardian/Relative will be required to accompany the applicant. In
case of incapacitated person, the signature will be done by Legal Guardian of Incapacitated Person.
about:blank 1/1
