Name: ....................................... Address - Collectorate North Goa

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Sub: Application for correction of details in the Ration Card. Sir / Madam,. I, the undersigned, would like to bring to your kind notice that in our Ration Card ...
Name: ....................................... Address:..................................... ................................................... .................................................... Dated: To, The Mamlatdar of .................... ................................................ Sub: Application for correction of details in the Ration Card Sir / Madam, I, the undersigned, would like to bring to your kind notice that in our Ration Card bearing No........................................................, there is a mistake in the name / surname of the family member at Sr. No.......... The correct name of the said person is............................................................... and same requires to be corrected. I am enclosing herewith copy of ........................................................ for doing necessary correction.

Signature of the applicant Encl: (1) Birth Certificate

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