TTA Trust Beneficiary Form
1. Personal Details
Applicant Name:
Father’s Name:
Mother’s Name:
Date of Birth:
Age:
Gender:
Male
Female
Other
Mark of Identification:
Category:
--Select--
General
OBC
SC
ST
Marital Status:
--Select--
Married
Unmarried
Widow
Divorced
Spouse Name:
2. Guardian/Caretaker
Name:
Contact Number:
3. Educational Details
--Select--
Primary
Middle/Higher Primary
Senior Secondary
Higher Secondary
Diploma
Graduate
PG Diploma
Post Graduate
Doctorate
4. Address
Correspondence Address:
PIN Code:
State:
District:
City/Sub-District/Taluk:
Village/Block:
5. Disability Details
Do you have a disability certificate?
Yes
No
Certificate Number:
Date of Issue:
Disability Percentage (%):
Issuing Authority:
Disability Type:
Disability by Birth?
Yes
No
Disability Since:
6. Employment & Income
Employed?
Yes
No
Unemployed Since (if applicable):
Occupation:
Personal Annual Income:
--Select--
Below 10,000
10,000 - 1,00,000
1,00,000 - 5,00,000
>5,00,000
Father’s Annual Income:
--Select--
Below 10,000
10,000 - 1,00,000
1,00,000 - 5,00,000
>5,00,000
Spouse’s Annual Income:
--Select--
Below 10,000
10,000 - 1,00,000
1,00,000 - 5,00,000
>5,00,000
7. Identity Details
Identity Proof:
Identity Proof Number:
Aadhar Card Number:
Declaration:
I hereby declare that what is stated above is true to the best of my knowledge.
Date:
Upload Applicant’s Signature/Thumbprint:
Submit Form
Print Form
