Group Leader’s Application No.

*

(Please read the instructions before filling)

Gender

Male Female

GOVERNMENT HAJJ SCHEMEData Collection Form For Hajj 2020 (1441 A.H)

Hajj Application No.

Photo with Light Blue

Background

of size 4 x 3 cm

may be pasted

with gum

Blood Group

Are You Mehramof Lady?

Yes No

Mobile Number

District (Postal Address)

Date of Expiry (Atleast 01-02-2021)Passport No.

NADRA’S Identity Card or NICOP No.

Given Name of Applicant (As per Passport )

Father/Husband’s Name

Present Postal Address (Please see Instructions)

Sur Name of Applicant (As per Passport ) Date of Birth (DDMMYYYY)

PWR ISB LHR KHI QTA SKR FBD

Place of Departure

SKTMLN RYK

Leader Member

Group Category

General Aged 70+ 3 years Unsucessful

ApplicantInformation

Amount in Rupees

Hajj App No. (2017)

*Hajj App No. (2018)

*Hajj App No. (2019)

*

Only for substitution cases,Substituted against Application No.

*

Tehsil (Postal Address)

Have You PerformedHajj in Last 5 years

Yes No

Nominee Information

Nominee’s Mobile No.

Nominee Name (must be adult and Blood relative)

Nominee NADRA’S Identity Card No.

Mobile Network

GroupInformation

Applicant Type

Group Size

Yes No

(For Shia Pilgrims Only)

0 3

Mehram/Helper’s InformationMehram’s Application No. (Female Applicants only)

*Relationship with Helper (Only Blood Relations)

Helper required for:

Aged 70+ Handicaped Other

Helper’s Application No.

0

Bank Logo

Yes No

3

Do you requireShia Facilities

Overseas Pakistani

øx»**x

Are You OverseasPakistani?

Yes No

Do you have NICOP?

Yes No

Years being Overseas Pakistani

Dues Deposit Date

2020

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