Haj 2010  Application Form
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Haj 2010 Application Form

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Haj 2010  Application Form Haj 2010 Application Form Document Transcript

  • HAJ COMMITTEE OF INDIA (Constituted under the Act of Parliament No. 35 of 2002) PROVISIONAL REGISTRATION FORM FOR HAJ - 1431 (H) – 2010 SUBMITTED THROUGH CONCERNED STATE HAJ COMMITTEE ONLY Please read the instruction and guidelines carefully before filling the Form, in ENGLISH & CAPITAL LETTERS in the blue/ black ball pen only. Furnish correct name and other information same as per international passport & attached Xerox copy of passport all co-applicants. It needs to be noted that the false information or suppression of facts shall lead to rejection of application. FOR OFFICE USE ONLY COVER NUMBER __________________ SIGNATURE OF EXECUTIVE OFFICER STATE HAJ COMMITTEE Details of non refundable provisional registration fee RS.200/- per pilgrim deposited in Haj Committee of India Account No. 30683623887 in any State Bank of India branch. Amount Name of Branch Branch Code No. Receipt Date (The Copy Of Pay-In-Slip Is Attached) No. of Adult = Infant = COVER HEAD (first applicant) should be MALE I. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished) Year Cover No. Year Cover No. Year Cover No. 2007 2008 2009 DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Full Name Mother’s Name Spouse Name Present Residential Address, Including Street Number with PIN code PIN CODE District State Telephone Number with Code Number :- Mobile No. :- MARITAL STATUS Occupation :- EDU. QUALI :- MARRIED / UNMARRIED Date of Birth Age :- Place of Birth DETAILS OF THE OTHER APPLICANT/S II. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished) Year Cover No. Year Cover No. Year Cover No. 2007 2008 2009 DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Full Name Mother’s Name Spouse Name SEX - Male / Female MARITAL STATUS MARRIED / UNMARRIED Occupation :- EDU. QUALI :- Date of Birth Age :- Place of Birth NAME OF MEHRAM WITH RELATION (for female pilgrims only) Name Relationship III. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished) Year Cover No. Year Cover No. Year Cover No. 2007 2008 2009 DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Full Name Mother’s Name Spouse Name SEX - Male / Female MARITAL STATUS MARRIED / UNMARRIED Occupation :- EDU. QUALI :- Date of Birth Age :- Place of Birth NAME OF MEHRAM WITH RELATION (for female pilgrims only) Name Relationship
  • IV. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished) Year Cover No. Year Cover No. Year Cover No. 2007 2008 2009 DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Full Name Mother’s Name Spouse Name SEX - Male / Female MARITAL STATUS MARRIED / UNMARRIED Occupation :- EDU. QUALI :- Date of Birth Age :- Place of Birth NAME OF MEHRAM WITH RELATION (for female pilgrims only) Name Relationship V. Applied for General / Reserved Category (for Reserved Category details of last 3 years rejected cover number must be furnished) Year Cover No. Year Cover No. Year Cover No. 2007 2008 2009 DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Full Name Mother’s Name Spouse Name SEX - Male / Female MARITAL STATUS MARRIED / UNMARRIED Occupation :- EDU. QUALI :- Date of Birth Age :- Place of Birth NAME OF MEHRAM WITH RELATION (for female pilgrims only) Name Relationship DETAILS OF INFANT/S (IF ANY ACCOMPANIED) 1. DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE Date of Issue Date of Expiry SELF ATTESTED Applicant:- Surname PHOTO Given Name Father’s Name Mother’s Name SEX - Male / Female Date of Birth Age :- Place of Birth :- 2. DETAILS AS PER INTERNATIONAL PASSPORT. (copy of valid passport should be attached) Passport Number Place of Issue PASTE SELF Date of Issue Date of Expiry ATTESTED Applicant:- Surname PHOTO Given Name Father’s Name Mother’s Name SEX - Male / Female Date of Birth Age :- Place of Birth :- Attached: Photo copy of passport for all applicants. OR (1) PROOF OF ADDRESS (ATTACH ONE OF THE FOLLOWING) (a) Ration Card (b) Driving License (c) Electricity Bill (d) Telephone Bill (Land Line) (2) PROOF OF CITIZENSHIP (ATTACH ANY ONE) (a) Voter’s Identity Card (b) Pan Card (c) Senior Citizen Card. NOTE : Pilgrim having performed Haj within five years are not eligible. Pilgrims of same district should apply in one cover. The intending Pilgrim shall submit one and only one application form individual or in Group of FIVE (5) Persons cover. In case submits more than one application form he/she shall be disqualified. SIGNATURE OF HEAD OF COVER *Photo copy of Form may also be
  • BANK COPY CA ACCOUNT PAY-IN-SLIP State Bank of India BRANCH ________________________ . CODE __________________ . DATE _______________________________ NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name) Haj Committee of India. Mumbai. Account No. 30683623887 PARTICULARS OF PILGRIMS, Cover No. ___________________________________ Accommodation Category Opted: - _____________________________________________ Name (Head of Cover) :- _______________________________________________________________________________ Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS. X 1000 Rs. X 500 Rs. X 100 Rs. X 50 Rs. X 20 Rs. X 10 Rs. Total No. of Persons X5 Rs. Amount (in words) Rupees _________________________________________ Total Rs. Rs. CASH OFFICER JOTTING CASHIER’S SCROLL NO. CASHIER PARTITION NO. PASSING OFFICER BOOK DEPOSITED BY Bank Stamp (SIGNATURE) to be affixed ----------------------------------------------------------------------------------------------------------------------------------------------- COPY – HAJ COMMITTEE OF INDIA, MUMBAI. (Constituted under the Act of Parliament No.35 of 2002) HAJ HOUSE, 7-A, M.R.A. MARG, (PALTON ROAD), MUMBAI-400 001. CA ACCOUNT PAY-IN-SLIP State Bank of India BRANCH ________________________ . CODE __________________ . DATE _______________________________ NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name) Haj Committee of India. Mumbai. Account No. 30683623887 PARTICULARS OF PILGRIMS, Cover No. ___________________________________ Accommodation Category Opted: - _____________________________________________ Name (Head of Cover) :- _______________________________________________________________________________ Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS. X 1000 Rs. X 500 Rs. X 100 Rs. X 50 Rs. X 20 Rs. X 10 Rs. Total No. of Persons X5 Rs. Amount (in words) Rupees _________________________________________ Total Rs. Rs. CASH OFFICER JOTTING CASHIER’S SCROLL NO. CASHIER PARTITION NO. PASSING OFFICER BOOK DEPOSITED BY Bank Stamp (SIGNATURE) to be affixed ----------------------------------------------------------------------------------------------------------------------------------------------- PILGRIM COPY CA ACCOUNT PAY-IN-SLIP State Bank of India BRANCH ________________________ . CODE __________________ . DATE _______________________________ NOTE : Branches are requested to return two copy to the depositor duly stamped for the credit of the Account of (Name) Haj Committee of India. Mumbai. Account No. 30683623887 PARTICULARS OF PILGRIMS, Cover No. ___________________________________ Accommodation Category Opted: - _____________________________________________ Name (Head of Cover) :- _______________________________________________________________________________ Sr. No. NAME OF THE PILGRIMS ADDRESS OF HEAD OF COVER CASH NOTE AMOUNT IN RS. X 1000 Rs. X 500 Rs. X 100 Rs. X 50 Rs. X 20 Rs. X 10 Rs. Total No. of Persons X5 Rs. Amount (in words) Rupees _________________________________________ Total Rs. Rs. CASH OFFICER JOTTING CASHIER’S SCROLL NO. CASHIER PARTITION NO. PASSING OFFICER BOOK Bank Stamp to be affixed DEPOSITED BY (SIGNATURE) NOTE :- Xerox copy of pay–in-slip may also be used for deposit of amount.
  • tIcf kwØm lÖv I½nän lÖv lukv, ]n.H. Imen¡äv FbÀt]mÀ«v, ae¸pdw þ 673 647. t^m¬: 0483 - 2710717 Ref. : H2-01/10 HAJ-2010 Xn¿Xn: 30þ03þ10 2010 lÖnv At]£n¡p¶Xnpff amÀKnÀt±i§Ä 1. At]£m t^mdw ]qÀ®ambpw hyàambn, Cw¥ojn henb A£c¯n ]mkvt]mÀ«n tcJs¸Sp¯nbXvt]mse ]qcn¸nt¡­XmWv. ]qÀ®aÃm¯ At]£ kzoIcn¡p¶XÃ. IhÀ eoUÀ ]pcpjmbncn¡Ww. kv{XoIÄ Hä¡v At]£ kaÀ¸n¡phm³ ]mSnÃ. 2. At]£bn Gähpw ]pXnb 2.5cmx2.5cm hen¸apÅ Hcp t^mt«m ]Xnt¡­XmWv. 3. 2007, 2008, 2009 hÀj§fn lÖnv XpSÀ¨bmbn At]£n¡pIbpw sXcsªSp¡s¸SmXncn ¡pIbpw sNbvXhÀ 2010þse lÖnv At]£n¡pIbmsW¦n Ahsc dnkÀhvUv ImäKdnbn DÄs¸Sp¯n dps¡Sp¸v IqSmsX lÖnv Xmsg ]dbp¶ n_ÔIÄ¡v hnt[bambn ApaXn ÂIphm³ lÖv I½nän Xocpamn¨n«p­v. aäpÅhÀ Pd ImäKdn (dps¡Sp¸v) hn`mK¯nemWv DÄs¸SpI. i) Hcp Ihdn At]£n¡p¶ apgph³ BfpIfpw 2007, 2008, 2009 hÀj§fn At]£n¨hcmbncn¡Ww. ii) Hmtcm At]£Isâbpw nÝnX tImf¯n ap³ hÀj§fnse IhÀ ¼dpIÄ nÀ_Ôambpw FgpXnbncn¡Ww. iii) IhÀ¼À sXämbn FgpXpItbm, aq¶phÀjhpw At]£n¡m¯hsc Ihdn DÄs¸Sp¯pItbm sNbvXm Hcdnbn¸pw IqSmsX Xs¶ Ahsc Pd ImäKdnbnte¡v amäp¶XmWv. iv) ap³ hÀj§fn sXcsªSp¡s¸SpIbpw F¶m GsX¦nepw ImcW¯m bm{X d±m¡pIbpw sNbvXhÀ¡v Cu BpIqeyw e`yaÃ. 4. lÖv 1431(H)2010 amÀ¤nÀt±i¯n ]dªn«pff amZWvU§Ä ]qÀ®ambpw ]men¨psIm­m bncn¡Ww At]£ kaÀ¸nt¡­Xv. 5. At]£bn ImWn¨ncn¡p¶ Imcy§Ä kXykÔambncn¡Ww. At]£bn IhÀeoUÀ H¸ntS­XmWv. AÃm¯]£w At]£ nckn¡p¶Xmbncp¡pw. 6. At]£ kwØm lÖv I½nän apJm´ncw am{Xta kzoIcn¡pIbpffq. 7. lÖnsâ ]qÀ® D¯chmZnXzw ]mÀesaâdn N«{]Imcw tI{µ lÖv I½nän¡pffXmWv. Pn±bnse¯p¶ C´y³ lmPnamcpsS {]iv§Ä Pn±bnse C´y³ tIm¬kpteäv ]cntim[n¡p¶Xpw amÀ¤nÀt±iw ÂIp¶XpamWv. lmPnamÀ¡v e`n¡p¶ kuIcy§fpsS taÂtm«w tI{µ lÖv I½nän nÀÆln¡p¶XmWv. 8. Xmsg ]dbp¶ hyànIÄ lÖv 1431(H) 2010þv At]£ kaÀ¸n¡phm³ ]mSnÃ. 1. Ignª A©v hÀj¯npffn (2006 þ 2009) lÖv sNbvXhÀ. 2. Sn._n., FbnUvkv, aäp kmw{IanI tcmK§fpffhÀ AwKsshIeyw, _p²namµyw XpS§nb imcocnI {]iv§fpffhÀ. 3. 31þ12þ2010þv 5 hbÊv XnIªXpw 16 hbÊv XnIbm¯Xpamb B¬Ip«nIÄ. 4. salvdw CÃm¯ kv{XoIÄ. 9. C³^âv: 31þ12þ2010þv c­v hbÊv ]qÀ¯nbmIm¯ Ip«nIÄ¡v AhcpsS amXm]nXm¡tfmsSm¸w At]£n¡mhp¶XmWv. 10. ]WaS¡Â:-þ 1) Hmtcm At]£tbmsSm¸hpw tÌäv _m¦v Hm^v C´ybpsS GsX¦nepw imJbn 30683623887--þF¶ A¡u­n HcmÄ¡v 200cq] hoXw nt£]n¨Xnsâ t]þC³þÉn]v DffS¡w sNbvXncn¡Ww. Cu XpI Xncn¨pÂIp¶XÃ. Unamâv {Um^vtäm, ]Wtam Hcp ImcWhimepw kznIcn¡p¶XÃ. Hcp Ihdn H¶nÂIqSpX At]£Icps­¦n apgph³t]cpsSbpw XpI H¶n¨S¡mhp¶XmWv. 2.)1431(H) 2010 lÖnpff At]£ kzoIcn¡p¶Xnpff Ahkm Xn¿Xn 30-04-2010 sshIpt¶cw 5 aWn hscbmWv. Ahkm XnbXn¡ptijw e`n¡p¶ At]£IÄ bmsXmcp ImcWhimepw kzoIcn¡p¶XÃ. At]£IÄ tIcf kwØm lÖv I½nän Hm^oknte¡mWv Abt¡­Xv. 11. bm{Xm kab¯v ]qÀ® KÀ`nWnIfmb kv{XoIÄ lÖv bm{Xm Hgnhmt¡­XmWv. IpSpw_ _ÔapÅ ]camh[n A©pt]À¡v Hcp Ihdn At]£n¡mhp¶XmWv. IhdnepÄs¸« At]£IcpsS ]WanS]mSnsâ NpaXe apJy At]£IpffXmWv. HcmÄ H¶ne[nIw At]£ kaÀ¸n¡m³ ]mSpffXÃ. A§s kaÀ¸n¨Xmbn sXfnªm AbmfpÄs¸Sp¶ apgph³ At]£Ifpw nckn¡p¶Xpw nbaS]SnIÄ kzoIcn¡p¶XpamWv. 12. At]£bn At]£IcpsS t^m¬ ¼À STD tImUv klnXw hyàambn ]qcn¸nt¡­XmWv. At]£bpsS Hcp t^mt«mÌmäv tIm¸n nÀ_Ôambpw At]£I³ kq£nt¡­XmWv. 13. lÖv I½nän¡v GP³knItfm Ap_Ô Øm]§tfm CÃ. Bhiy¯ne[nIw XpI hyànItftbm GP³knIsftbm Gev]n¨v h©nXcmImXncn¡pI. 14. lÖpambn _Ôs¸« FÃmImcy§fnepw tI{µ lÖv I½nänbpsS Xocpamw A´naambncn¡pw. 15. 1431(H) 2010 lÖnpff At]£ FIvknIyq«ohv Hm^oÊÀ, tIcf tÌäv lÖv I½nän Hm^okv, lÖv lukv, ]n.H. Imen¡äv FbÀt]mÀ«v, ae¸pdw þ 673 647 F¶ hnemk¯n 30þ04þ2010þv sshIp. 5 aWn¡pap¼mbn e`nt¡­XmWv. At]£tbmsSm¸w, 5 cq] Ìms¼m«n¨ IhÀeoUdpsS taÂhnemksagpXnb c­p IhdpIÄ, FÃm At]£IcpsSbpw ]mkvt]m«nsâ tIm¸n F¶nh D­mbncn¡Ww. At]£ Ab¡p¶ Ihdnv ]pd¯v ""lÖv At]£þ 2010''F¶pw, sam¯w At]£IcpsS F®hpw FgptX­XmWv. At]£ Ab¨v ]Xn©v Znhk¯nIw IhÀ ¼À e`n¨n«nsæn At]£bpsS t^mt«m tIm¸n klnXw lÖv I½nän Hm^oÊpambn _Ôs¸tS­XmWv. 16. 2010þse lÖnmbn XncsªSp¡s¸Sp¶hÀ¡pÅ S]SnIsf¡pdn¨pÅ hnhc§Ä ]n¶oSv Adnbn¡p¶XmWv. hntZi hnnab kwJybpsSbpw hnam¡qenbpsSbpw 30 iXamhpw C³ÀmjW ]mkvt]mÀ«pw 2010 sabv amk¯n kaÀ¸nt¡­XmWv. _m¡n 70 iXamw 2010 BKÌv 31þIw ASbvt¡­XmWv. (H¸v) PnÃm- I-fIvSÀ, ae¸pdw & FIvkn-Iyp-«ohv Hm^o-kÀ