APPLICATION FORM
FOR IDENTITY CARDS TO THE SENIOR CITIZENS IN THE STATE OF KARNATAKA
ISSUED BY THE DEPARTMENT OF WELFARE OF DISABLED & SENIOR CITIZENS, GOVT. OF KARNATAKA.
Name & Address of the Association Approved for the issues of ID Cards by Govt of Karnataka.
Senior Citizen Forum CBR NETWORK
#134, 6 Main, 1 Block, 3 Phase, Banashankari 3 Phase, Bangalore – 560085, Phone : 26724221
TO BE FILLED BY CITIZENS OF KARNATAKA WHO HAVE COMPLETED SIXTY YEARS OF AGE AS ON THE DATE OF FILLING UP OF THE APPLICATION
AS TO APPEAR ON THE CARD – TO BE FILLED BY THE APPLICANT