evsjv‡`k †emvgwiK wegvb PjvPj KZ…©c‡ÿi AMv©‡bvMÖvgfz³ PvKzwiiZ Kg©KZ©v I Kg©Pvixi AbyK~‡j g…Zz¨ ev ’vqx

AÿgZvRwbZ Avw_©K Aby`vb cÖ v‡bi Av‡e`b dig|

eivei

‡Pqvig¨vb

†emvgwiK wegvb PjvPj KZ…©cÿ

m`i `ßi, Kzwg©‡Uvjv, XvKv|

welqt g…Zz¨/ ’vqx AÿgZvRwbZ Kvi‡Y Avw_©K Aby`v‡bi Rb¨ Av‡e`b|

g‡nv`q,

webxZ wb‡e`b GB †h, Avwg/Avgvi ¯vgx/ ¿x................................................................ `߇i

...................................................... c‡` Kg©iZ AvwQ/wQ‡jb| Avwg/wZwb..................................

Zvwi‡L B‡šÍKvj K‡i‡Qb/ ............................................ A½nvwb n‡q ’vqxfv‡e Aÿg n‡qwQ (AcÖ‡qvRbxq

Ask †K‡U w`‡Z n‡e)| wb‡¤œ cÖ‡qvRbxq Z_¨vw` Avcbvi m`q AeMwZi Rb¨ †ck Kiv n‡jvt

("K" Askt Kg©Pvix/cÖK…Z DËivwaKvix KZ…©K c~iY Ki‡Z n‡e I AcÖ‡qvRbxq Ask c~iY Kivi `iKvi †bB)

(K) Kg©KZ©v/Kg©Pvixi bvg (evsjvq) t

(Bs‡iwR‡Z eo Aÿ‡i)

(L) wcZvi/¯vgxi/ ¿xi bvg (evsjvq) t

(Bs‡iwR‡Z eo Aÿ‡i)

(M) c`ex (evsjvq) t

(Bs‡iwR‡Z eo Aÿ‡i)

(N) Awd‡mi bvg I wVKvbv t

(O) Av‡e`bKvixi bvg I wVKvbv t

(g…Z Kg©KZ©v/Kg©Pvixi †ÿ‡Î DËivaxKvix)

Av‡e`bKvixi GK

Kwc iwOb

cvm‡cvU© mvB‡Ri

mZ¨vwqZ d‡Uv

- 02 -

(P) Av‡e`bKvixi RvZxq cwiPqcÎ bs (mZ¨vwqZ t

d‡UvKwc mshy³ Ki‡Z n‡e)

(Q) Av‡e`bKvixi mv‡_ mswkøó Kg©KZ©v/Kg©Pvixi m¤ú©K t

(R) ‡dvb/‡gvevBj/B-‡gBj bs t

(S) e¨vsK wnmve b¤i t

e¨vs‡Ki bvg I e¨vs‡Ki kvLvi bvg

(‡h wnmv‡e Aby`v‡bi A_© †c‡Z B”QzK)

(T) Kg©KZ©v/Kg©Pvix Rb¥ ZvwiL t

(U) PvKywi‡Z †hvM`v‡bi ZvwiL t

(V) Kg©KZ©v/Kg©Pvix AMv©‡bvMÖvgfz³ wKbv t

(W) Kg©KZ©v/Kg©Pvixi DËivwaKvixi bvg I wVKvbv

(Dchy³ KZ…©c‡ÿi mb` mshy³ Ki‡Z n‡e)

(X) g…Z e¨w³i c‡ÿ Av‡e`b Kivi Rb¨ Ab¨vb¨ t

DËivwaKvixMY KZ…©K cÖ Ë ÿgZvcÎ

(Y) mswkøó Kg©KZ©v/Kg©Pvixi g…Zz¨i ZvwiL t

(g…Zz¨ mb` mshy³ Ki‡Z n‡e)

(M) ÿwZMÖ ’ A‡½i weeiY (AÿgZvi mg_©‡b t

wPwKrm‡Ki KvMRcÎ mshy³ Ki‡Z n‡e)

(_) cÖvw_©Z UvKvi cwigvY t

AZGe, Avgvi Av‡e`b m`q we‡ePbvc~e©K Aby`vb gÄywii Rb¨ webxZ Aby‡iva KiwQ|

Av‡e`bKvixi ¯vÿi

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Av‡e`bKvixi ¯vÿi

mxj/eZ©gvb wVKvbv

- 03 -

'L' Askt (wbqš¿YKvix KZ…©cÿ KZ…©K c~iYxq, AcÖ‡qvRbxq Ask †K‡U w`‡Z n‡e)

G g‡g© cÖZ¨qb Kiv hv‡”Q †h, Rbve/‡eMg ............................................................ c`ex

........................ ...................... I Kg© ’j ...........................................................AÎ Awd‡mi

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.................................. UvKv Avw_©K Abyy`vb cÖ v‡bi Rb¨ mycvwik Kiv n‡jv| G Kg©KZ©v/Kg©Pvixi

Av‡e`bc‡Îi 'K' As‡k ewY©Z Z_¨vw` mwVK| Zvui AbyK~‡j G ai‡Yi †Kvb Avw_©K Aby`v‡bi Av‡e`bcÎ c~‡e© AÎ

`ßi †_‡K †cÖiY Kiv nqwb|

wbqš¿YKvix KZ…©c‡ÿi ¯vÿi I ZvwiL

bvghy³ mxj I wVKvbv

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m`i `ßi, Kzwg©‡Uvjv, XvKv|

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G g‡g© cÖZ¨qb Kiv hv‡”Q †h, Rbve/‡eMg....................................................

c`ex.....................................................I Kg© ’j.....................................................

Gi KvMRcÎ/Zvu‡K A`¨ ................................................................... Zvwi‡L cixÿv Kiv

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n‡q‡Q|

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¯vÿi I ZvwiL

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¯vÿi I ZvwiL

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¯vÿi I ZvwiL