Ministry of Social Justice and Empowerment (MSJE)

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भारत सरकारGOVERNMENT OF INDIA
दिव्यांगजन सशक्तिकरण विभाग Department of Empowerment of Persons with Disabilities (Divyangjan)
सामाजिक न्याय एवं अधिकारिता मंत्रालय Ministry of Social Justice and Empowerment (MSJE)

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LLC PWD APPLICATION FORM

LLC PwD Details

LLC PwD name *:

State * :

LLC Pwd District * :

Address * :

Pincode *:

City :

Mobile No *:

Phone No :

Email ID*:

Upload recommendation letter of the DC/DM of the said district
FILE FORMAT(pdf)*:

Upload disability certificate
FILE FORMAT(pdf)*:

Bank Details of LLC (A joint account with DC/LLC chairperson is to be opened in the name of "Local Level Committee District Name" & Provide details of that account)

Name of the Account Holder :

Bank account no. :

Bank Name :

Branch Name:

Branch City :

IFSC code :

Captcha :

Please fill all * Marked mandatory fields