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. Address* (as in documentary proofs submitted) Name 2. City* (as in documentary proofs submitted) Address 3. Postal code 4. County (in the case of an address registered in a single town, state, union Territory and/or other area in Tamil Nadu) 5. State* ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** ******** Name/E-mail: Your name/E-mail address with a letter at the start: E-mail address (as in documentary proofs submitted): If the e-mail is not connected to your bank account under the address which is registered on your Mobile to your e-mail-ID, please tell this fact. If you do not have any e-mail-ID or any connection with a bank, please tell this fact. The following information is necessary to establish identity: (1) Name of a person residing in the same place as well as address where such person resides; (2) Date, time and duration (a) You are 18 years; b) (in the case of a case of marriage of minor, you must give the last date of birth); c) (in case of birth of any person or person of marriageable age, you must give the date and hour of birth and also the place of birth); d) (in case of all others, the fact of marriage or birth is known or must be known to you); e) (in case of death, you will have to inform the closest family members) (3) Telephone number of the telephone numbers under which you get telephone service; (4) Date, time and duration (a) You are 18 years; (b) (in the case of a case of marriage of minor, you must give the last date of birth); (c) (in the case of birth of any person or person of marriageable age, you must give the date and hour of birth and also the place of birth); (d) (in case of all others, you may give the date and hour of your last arrival from home and last leave from work, but you must make it clear that you are unable to give the time) (5) Identity card issued by the government in your name; (6) Photograph (including colour photos taken by

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