Application No:
APPLICATION FOR MEESEVA FRANCHISEE AUTHORIZED AGENT
Applying for the Municipality / Corporation : Tirupati [ ];
Punganur [ ] ;
Applying For The Location / Area
Contact No:
Mail ID:
Chittoor [ ];
Nagari [ ];
Palamaner [ ];
Madanapalli [ ]
[for DeGS Sanctioned Locations only]
APPLICANT NAME
APPLICANT FATHER / HUSBAND NAME
APPLICANT PARMANENT ADDRESS
APPLICANT PRESENT ADDRESS
APPLICANT Educational & Tech., Qualifications:
Experience if any
GENDER
RELIGION & CASTE
ANY Room is available at applying Location
YES [ ] ;
IF YES, Room Size / Area [in Sq.ft.]
Width:
Give Full Address Of The Room
Details, If any existing business in this Room
NO [ ]
Ft X Length:
Ft =_______Sq.ft.
Signature of the Applicant
Application will reach on or before 15.06.2015 to
the Project Manager, HCL Infosystems Ltd., C/o. Mee Seva, Municipal Office Premises, Tirupati
Acknowledgement
Application No
:
Applied Municipality:
Applicant Name :
Applied Location:
Sign: