DC(Handicrafts),Government of India.

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Aadhaar Number

Name of Artisan

Photo

ID Card no

Date of Issue

Recognition

Gender

Category

Father/Husband Name

Address

State

District

Mobile

Craft Practice

Sub Craft Practice

Craft Experience

Past Haat-Bazaar-Exhibition attended in last five years

Sr. No	Event Type	Haat-Bazaar-Exhibition	Venue	Period	Assistance Name	ID Card No	Adhaar No	Remarks	Action
1									Update Cancel

Stall No

Assistance detail who will support you in Exhibition

Sr. No	Name	Relation	Photo	ID Card No	Adhaar No	Remarks	Action
1							Update Cancel

Financial Details :-

Bank name

Account No

IFSC Code

Fee/Security Deposited if any

PDD no

Amount

Date

I hereby
(A Declare that information given above is true to the best of my knowledge. Any information, that may be to be verified, shall be provided immediately before the concerned authority.
(B) Undertake that I have not been blacklisted/debarred by the O/oDC(H) during the last three Years. I also undertake that if I am selected for the event and I do not participate due to any reason, then I am liable for blacklisting and my Security Deposit will be forfeited.