SSEPD::Social Security & Empowerment of Persons With Disabilities Department

Madhu Babu Pension Yojana Application Form

Madhu Babu Pension Yojana Application Form
Pension Type	:	Old Age Pension		Name	:	PARBATI PARIDA
Father's/Spouse Name	:	SANKAR PARIDA		DOB	:	01-01-1960
AGE	:	61		Aadhar No	:	276309418563
	Gender	:	Female
Mobile No	:	8114397648		District	:	PURI
Sub-division	:	PURI		Address Type	:	Block
Block	:	KANAS		GP	:	BADAS
Village	:	BADAS		Habitation	:	BADAS
House No/Plot No	:	25		PIN	:	752017
Social Category(Caste)	:	General
The parental/family income of the applicant is not more than Rs.60,000/-per annum.	:	Yes		Has not been convicted of any criminal offence involving moral turpitude.	:	Yes
Is a permanent resident/domicile of Odisha since 20 years.	:	Yes		Application Number	:	SSEPD/BNFAPP/MBPY/10/20/2021/739791

Bank Account Details
Bank Account Type	:	Single Account	Account Holder Name	:	PARBATI PARIDA
Account Number	:	004901000018108	IFSC Code	:	IOBA0ROGB01
Bank Name	:	ODISHA GRAMYA BANK	Branch Name	:	ODISHA GRAMYA BANK

Declaration

I Mr/Mrs PARBATI PARIDA truely declare that:

The parental/family income of the applicant is not more than Rs.60,000/-per annum.

Has not been convicted of any criminal offence involving moral turpitude.

Is a permanent resident/domicile of Odisha since 20 years.

I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately.In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it and that my pension will be terminated.

Back