APPLICATION FORM FOR TEMPORARY HOUSE HELP RESOURCES Date

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To The Akruti Niharika Complex Association Office Saiwadi, Andheri East, Mumbai - 400 069 Dear Office Bearers I Mr./ Ms. within the Complex since

working as a Domestic Servant at various flats months/ years wish to apply for Identiy Card to enable my entry into

complex. Following are the flats where I currently extend my services:Job Role Building Flat No.

Flat Owner Sign

Following details and information being submitted for your records Spouse Name Telephone Contact no. (Residence and Mobile) Present Residential Address Self Telephone Contact no. Address Proof Submitted

PAN card/ Ration Card/ Voters ID/ Passport

Local Police Verification (Mandatory)

Police Station -

Permanent Residential Address Telephone Contact no. Address Proof Submitted Permanent Resident Police Verification 2 Passport/ ID Size Photograph (in addition to a Photo attached to this Application)

PAN card/ Ration Card/ Voters ID/ Passport Submitted/ Not Submitted Submitted/ Not Submitted

Vide this application, I also assure on ensuring adherance to the laid out guidelines and would ensure appropriate behaviour . Signature of Domestic Servant

For office Use Only ID Card Ref. no.

Preliminary verification done by (Name and Sign)