Appendix 'D' APPLICATION FOR ISSUE OF IDENTITY CARD FOR EX-SERVICEMEN 1. Number ___________________ 2. Rank ____________________ 3. Name ________________________________________________ 4. Regiment/Corps ________________________________________ 5. Father's Name _________________________________________ 6. Address Tehsil or Police Station ________________________ Tele : 7. Date of Birth _________________________ 8. Date of Enrolment _______________________ 9. Date of Discharge _______________________ 10. Amount of Pension (a) Service Pension Rs. (b) Disability Pension Rs. (c) Percentage of Disability 11. Discharge Book No. & Date 12. P.P.O. No. & Date 13. Identification Mark 14. Left Thumb Impression DECLARATION I hereby declare that the particulars given above are true to the best of my knowledge and belief. Date : _____________________ Place : ____________________ (Signature of the Applicant)
