Appendix-A
KPKB CANTEEN CARD FORM
1. FORCE NO./ PPO NO…………………………………………..
2. RANK: Officer SO OR’s
3. NAME:……..…………………………………………………… Affix Photograph
4. NAME OF ORGANIZATION: ……………………………
5. UNIT / HQ: ……………………………………………………
6. DEPT. ID CARD NO……………….……………………………
7. MONTHLY LIMIT OF PURCHASE: (I) GROCERY : (Rs.)…………………………..
(II) AFD : (Rs.) …………………………..
8. SERVING / RETIRED:………..………………………………
9. ADHAR CARD NO. …………………………………………
10. MOBILE NO.: …………………………………………
11. DETAILS OF KPKB BENEFICIARIES:-
SL NAME & ADDRESS Relation with Limit of ID Card/ Adhar/ AFD
Beneficary Purchase (in Rs) Ayushman No Quata
01
02
12. UNDERTAKING:
“I hereby declare that the information provided above is true to the best of my
knowledge. I understand the KPKB Bhandar Card is issued for my personnel use only and I will
be responsible for any misuse. I also declare that I have not applied any other KPKB Bhandar
Card earlier. If found so, appropriate disciplinary action/suspension of my KPKB Card may be
taken against me.”
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Date:……………
Place……………… Signature of Individual
COUNTER SIGNATURE
INSTRUCTIONS
1. Necessary Documents:-
(a) Photocopy of Employee ID Card (Self attested).
(b) Photocopy of Service Certificate / Ayushman Card / Dependent Certificate
(c) Photocopy of PPO Card / Letter OR ADHAR Card (For Retired Person).
(d) Passport Size Color Photograph of Primary & Secondary beneficiary with mentioned Force
No. & Name (to affix KPKB Canteen Card).
(e) Applicant need to mention in which card he wants to avail AFD facility in column no.11.
2. PURCHASE LIMIT:-
Sr. Rank Monthly limit value for items Annual Limit (AFD items
No. (grocery/consumable items) or items above Rs. 1200/-)
1 Officers and Equivalent 11000/- 100000/-
2 SOs and Equivalent 9000/- 100000/-
3 ORs and Equivalent 8000/- 75000/-
(i) Items having value more than 1200/- will be automatically counted into the annual limit.
(ii) Eligibility criteria for other AFD (Against Firm Demand) items (viz) AC/Fridge/ Washing
Machine/Laptops/Desk-Tops etc.
(a) TVs: Two TVs in a block period of four years.
(b) ACs: Four ACs in a block period of four years.
(c) AFD-1 items will be supplied only & only against the demand by beneficiary.
AFD (Against Firm Demand)
AFD-1 AFD-2
Air conditioner, Almirah, Batteries, Bed (Iron & Wooden), Items below the Sale Value of Rs.
Bicycles, Deep Freezer, Desert Cooler, Dish Washer, Laptop, 15000/- each and not covered
Mobile Phone, Music System, Refrigerator, Tablet, under AFD-I
Tea/Coffee, Vending Machine, Television, Washing Machine, May be stocked in Bhandars based
Water Cooler, Air Purifier, Desktop, Chapati Maker, Sofa, on the assessment requirements
Mattress and Items above the Sale Value of Rs. 15000/- each.
