Personal Details & Document Verification Form

1. Upload Documents

Mimal Limlak / Recent Passport Size Photo JPG, JPEG, PNG only. Max 5 MB. Aadhaar Card Limlak / Front Side Upload clear front image. Prefer Masked Aadhaar. Aadhaar Card Limlak / Back Side Upload clear back image. JPG/PNG only.

2. Personal Details

Min / Name Applicant Mobile Number Pa' Min / Father's Name Pian Ni / Date of Birth Beh Min / Clan Name Nasep / Occupation Aadhaar Last 4 Digits Only

Omdetna Mun / Permanent Address Tulel a Omna Mun / Current Address Taksa Pum a Cheptehtheihna / Identification Mark Thukin om hun a thuzaktheihna ding / Emergency Contact Person & Number

3. Confirmation

I confirm that the information and uploaded documents are genuine and correct. I understand that incorrect or fake documents may be rejected after verification.

For privacy, collect Masked Aadhaar wherever possible. The system stores uploaded images and creates a Word file for office use.