citizens handbook

Citizen’s Handbook

Index

OFFICE OF THE COLLECTOR & DISTRICT MAGISTRATE

I. DOMICILE CERTIFICATE....................................................... 3

II. ARMS LICENCE....................................................................3 (A) For self protection (B) For crop protection (C) For Renewal of Arms License

III. REFUND OF STAMP PAPER...................................................4

IV. REFUND OF FRANKING........................................................4

V. REFUND OF COURT FEE......................................................4

VI. ADJUDICATION OF FOREIGN POWER OF ATTORNEY (P.O. A)....4

VII. ADJUDICATION OF FOREIGN BIRTH / DEATH / MARRIA GE CERTIFICATE/ DIVORCE CERTIFICATE/BAPTISM CERTIFICATE..4

VIII. ADJUDICATION OF AFFIDAVIT..........................................4

OFFICE OF THE DEPUTY COLLECTOR & SUB-DIVISIONAL OFFICER

IX. SC/ST CERTIFICATE.........................................................5

X. OBC CERTIFICATE...........................................................6

XI. RENEWAL OF OBC CERTIFICATE........................................6

XII. PARTITION.....................................................................7

XIII. CONVERSION.................................................................7

XIV. SOUND PERMISSION UPTO 10 P. M...................................7

Page 1


Page 48

1.

2.

Citizen’s Handbook Citizen’s Handbook

Index

OFFICE OF THE MAMLATDAR & EXECUTIVE MAGISTRATE

XV. RESIDENCE CERTIFICATE.....................................................8

XVI. DIVERGENCE CERTIFICATE..................................................8

XVII. INCOME CERTIFICATE ISSUED ONLY FOR MEDICLAIM............9

XVIII. INCOME CERTIFICATE ISSUED ONLY FOR SPORTSPERSON....9

XIX. CERTIFICATE OF DEPENDENCY (Incase of death)....................9

XX. CERTIFICATE OF DEPENDENCY (Incase of Surviving and old aged dependants)...............................................................10

XXI.CERTIFICATE FOR UNEMPLOYED CHILDREN OF FREEDOM FIGHTERS......10

XXII. MUTATION.......................................................................10

OFFICE OF THE CIVIL SUPPLIES INSPECTOR

XXIII. NEW RATION CARD.........................................................11

XXIV. SEPARATE RATION CARD................................................ 11

XXV. ................................. 11 NAME INCLUSION IN RATION CARD

XXVI. NAME CORRECTION IN RATION CARD................................12

XXVII. DUPLICATE RATION CARD..............................................12

XXVIII. CANCELLATION CERTIFICATE.........................................12

Note: 1. In case if the issuing authority requires any additional documents, the same will have to be pro vided by the applicant.

2. The applicant must provide contact n umber on the application.

Page 2 7

K onkani Pages 13 to 30

M arathi Pages 31 to 48



I. DOMICILE CERTIFICATE

1. Application in prescribed form. 2. Birth Certificate. 3. Residence Certificate (preceding 5 years). 4. Educational qualification certificate. 5. Identity proof e.g. Voter’s card, PAN card, D rivin g

License, Passport copy, Aadhar card, etc.(Any one). 6. 2 Photos (Passport size). 7. Affidavit on Rs.50/- stamp paper. 8. Prescribed processing fees.

II. ARMS LICENCE

(A) For self protection

1. Application in prescribed form. 2. Birth Certificate. 3. Identity proof e.g. Voter’s card, PAN card, D r iving

Licence, Passport copy, etc. (Any one). 4. Income Tax returns of last 3 years. 5. Business Registration certificate (if any). 6. 3 Photos (Passport size). 7. Audited Statement for preceding financial year (X erox

Copy). 8. Prescribed processing and License fees.

*(Note: above documents to be given in 3 sets)

(B) For crop protection

1. Application in prescribed form. 2. Birth Certificate. 3. Identity proof e.g. Voter’s card, PAN card, Dri v in g

Licence, Passport copy, etc. (Any one). 4. Original Form I and XIV (latest copy). 5. 3 Photos (Passport size). 6. Prescribed processing and License fees.


Page 3

Self Attested Copies

(Sr. No. 2—5 )

Attested / Notarized

Copies

(Sr. No. 2—5 )


Copies

(Sr. No. 2 & 3 )

(C) Renewal of Arms Licenses (Self and Crop Protection)

1. Application in prescribed form. 2. Original Arms License. 3. Prescribed processing and License fees.

Page 46


III. REFUND OF STAMP PAPER

1. Application for refund on plain paper. 2. Original stamp papers. 3. Challan from Vendor. 4. Vendor’s certificate. 5. TR 41 form and Bank details form (prescribed form).

IV. REFUND OF FRANKING

1. Application for refund on plain paper. 2. Original franking papers. 3. Challan from bank. 4. Original payment slip. 5. Confirmation letter from bank. 6. TR 41 form and bank details form (prescribed form).

V. REFUND OF COURT FEE

1. Application for refund on plain paper. 2. Original Refund Certificate from Court. 3. Challan from Vendor. 4. TR 41 form and bank details form (prescribed form).

Page 4


VI. ADJUDICATION OF FOREIGN POWER OF ATTORNEY (P.O.A)

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of POA. 3. Special adhesive stamp of Rs.500/- (in case P O A is given for

transfer of Property by sale etc. ) ( In all o the r cases Special adhesive stamp of Rs.100/-)

4. Identity proof /address proof of attorney holde.r (e.g. Voter’s card, PAN card, Driving Licence, Passport, etc.)

5. Prescribed processing fees.

VII. ADJUDICATION OF FOREIGN BIRTH/DEATH/MARRIAGEC E R TIFICATE/ DIVORCE CERTIFICATE/BAPTISM CERTIFICATE

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of the relevant certificate.

(Foreign Birth/ Death/ Marriage Certificate/ Divorce Certificate/ Baptism Certificate).


VIII. ADJUDICATION OF AFFIDAVIT

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of the Affidavit. 3. Special adhesive stamp of Rs.50/-


Page 45


IX. SC/ST CERTIFICATE

1. Application in prescribed form along with a photo attached and Rs.5/- court fees stamp.

2. Birth certificate of the applicant (Self Attested). 3. Birth certificate of applicant’s father or any relatives from

father’s side (Self Attested). 4. Applicant’s school leaving certificate and bonafi d e certificate

issued by school authorities (Self Attested). 5. Documents showing that applicant’s father or gra n d f ather

belong to SC/ST notified by Government (Self Attested). 6. Documents showing that applicant / applicants Family w a s

residing in Goa prior to 19/02/1968 (Self Attested). 7. Self Declaration. 8. Samaj certificate (Self Attested). 9. Talathi’s report along with report of the concern ed Mamlatdar

(Original). 10. Marriage certificate for married woman (Self Attested). 11. Additional 2 photo’s of applicant (Passport size). 12. Aadhar card/Voter’s card (if any) (Self Attested).

*Note: No Income Certificate is required for ST/SC certificates.

Page 5


Page 44



X. OBC CERTIFICATE

1. Application in prescribed form along with a photo a ttached and Rs.5/- court fees stamp.

2. Birth certificate of the applicant (Self Attested). 3. Birth certificate of applicant’s father or a n y r latives from e

father’s side (Self Attested). 4. Applicant’s school leaving certificate or bonaf d e certificate i

issued by school authorities (Self Attested). 5. Documents showing that applicant’s father or gra n d father

belong to OBC notified by Government (Self Attested). 6. Document showing that the applicant/ applicant’s father was

residing in Goa prior to 19/02/1968 (Self Attested). 7. Self Declaration. 8. Samaj certificate (Self Attested). 9. Income certificate issued by the competent authority for

preceding 3 years. (Village Panchayat / Municipality / C.C.P.) (Original).

10. Talathi’s report along with report of t h e concerned Mamlatdar (Original).

11. Marriage certificate in case of marr i e d w o man (Self Attested).

12. Additional 2 photo’s of applicant (Passport size). 13. Aadhar card/Voter’s card (if any) (Self Attested).

XI. RENEWAL OF OBC CERTIFICATE

1. Application in prescribed form along with a phot o a ttached and Rs.5/- court fees stamp.

2. A copy of social status certificate (caste certif i c a te) issued earlier by the concerned Dy. Collector a n d S DO. (Self Attested).

3. Fresh income certificate issued by the compete n t authority for preceding 3 years. (Village Panchayat / Municip a l i t y / C.C.P.) (Original).

4. Confirmation letter of the social status certifi c a te issued to the applicant by the Director of Soci a l W e l fare (Self Attested).


Page 6 Page 43

5



XII. PARTITION

1. Application with Rs.5/- court fees stamp. 2. Form I and XIV (1 original + 1 attested / notarised) *

3. Site plan i.e. plan showing the area to be partitioned (1 original +1 Xerox). 4. Survey Plan ( 1 original + 1 Xerox). 5. Title / Ownership documents e.g. Sale deed etc. (1 notarised/attested + 1 Xerox).

XIII. CONVERSION

*Note: Area less than 500 sq. meters application to be made to the Dy. Collector and SDO. Area more than 500 s q. meters application to be made to the Collector .

1. Application in prescribed form with Rs.5/- court fees stamp. 2. Form I & XIV (1 original + 4 Xerox copies). *3. Survey plan ( 1 original + 4 Xerox copies). 4. One Notarized Copy of Sale Deed etc. and 4 Xerox copies of

the deed. 5. Site plan on the basis of Survey plan ( 1 original + 4 Xerox copies). 6. Manual copy of Form I & XIV maintained by the Talathi’s office.

XIV. SOUND PERMISSION UPTO 10 P. M.

1. Application in prescribed form. 2. Permission of Land owner. 3. Permission of Local Authority ( C.C.P. / Villa g e Panchayat /

Municipality) 4. Incase of Wedding – Wedding card/Booking receip t o f the

place / N.O.C from hall. 5. Incase permission needed on beach – N.O.C. from C RZ and

Tourism Department. 6. In case permission needed on vehicle then applic a n t to

specify the vehicle numbers along with attested Xerox copies of Registration of Certificate (R. C.) book.

Page 7

* Form I & XIV : Application on plain paper with Rs.5/- court fees stamp stating village

name and survey number. (office of the Mamlatdar)

Page 42





XV. RESIDENCE CERTIFICATE

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth Certificate. 3. Residence Certificate (old copy, if any). 4. Educational qualification certificate.(School L eaving or

Bonafide Certificate) 5. Identity proof e.g. Voter’s card, PAN card, Driv i n g

Licence, Passport copy, Aadhar card etc. (Any one) 6. Marriage Certificate (Incase of married woman). 7. LPG Connection (Incase of rented premises). 8. Self Declaration. 9. Self Declaration (N. O. C.) of the house owner ( I n c a se of

rented premises). 10. 2 Photos (Passport size).

Note: Those applying for the purpose of Portuguese Passport shall furnish additional documents as follows:

11. Indian Passport copy (Self attested Xerox copy). 12. While collecting certificate— 1 govt. witne s s ’ s signature

along with name and designation and name of office.

*Note: 1) These documents are to be supported by Ta lathi’s report.

XVI. DIVERGENCE CERTIFICATE

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth Certificate. 3. School Leaving Certificate. 4. Voting Card/Aadhar card (only as Identity proof). 5. Marriage Certificate (Incase of married woman) (if any). 6. Passport Copy (not compulsory). 7. Self Declaration. 8. If Govt. employee – Service book, pension book/ or d er (Self

Attested).


Page 8

Self Attested Copies (Sr. No. 2—7 )

Page 41




XVII. INCOME CERTIFICATE ISSUED ONLY FOR MEDICLAIM

1. Application in prescribed form with Rs.5/- C o u r t fees stamp.

2. Birth Certificate. 3. School Leaving Certificate.

4. Voter’s Card. 5. Doctor’s Certificate. 6. Marriage Certificate (incase of married woman). 7. Ration card copy. 8. Original Income certificate from C.C.P./Village P a nchayat/

Municipality. 9. Self declaration stating the no. of family membe r s , part

no., sr. no., constituency no. and name on the elect o r a l roll published in the current year.


XVIII. INCOME CERTIFICATE ISSUED ONLY FOR SPORTSPERSON

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth / School Leaving Certificate. 3. Marriage Certificate (incase of married woman). 4. Letter from Sports Authority of Goa issued to th e applicant. 5. Identity proof of the Applicant e.g. Voter’s card , PAN card,

Driving Licence, Passport copy, Aadhar card etc. (Any one) 6. Original Income certificate from C.C.P./Village P a nchayat/

Municipality.

*Note: 1) These documents are to be supported by Talathi’s report.

X X. CERTIFICATE OF DEPENDENCY I (Incase of death).

1. Application on plain paper. 2. Death Certificate (attested/notarized). 3. Birth Certificate of the Applicant and ot h e r children

including married daughter. 4. Identity proof of the Applicant e.g. Voter’s car d , P A N

card, Driving Licence, Passport copy, Aadhar card et c . (Any one).

5. Marriage Certificate (if any) (incase of married woman). 6. Deed of Succession, Inventory Proceedings (if any)

(attested/notarized) 7. Self Declaration.


Page 9

Self Attested

Copies

(Sr. No. 2—7 )

Self Attested

Copies

(Sr. No. 3—5 )

Page 40

Self Attested

Copies

(Sr. No. 2—5)



XX. CERTIFICATE OF DEPENDENCY (Incase of Surviving and old aged dependants)

1. Application on plain paper. 2. Birth Certificate of the Applicant (Self Attested). 3. Identity proof of the Applicant e.g. Voter’s card , P AN card,

Driving Licence, Passport copy, Aadhar Card, etc.( Any one) (Self Attested).

4. Self Declaration of the Applicant. 5. Self Declaration of the Dependant.


XXI. CERTIFICATE FOR UNEMPLOYED CHILDREN OF FREEDOM FIGHTERS


XXII. MUTATION

1. Application with Rs.5/- court fees stamp. 2. Form I and XIV (original). * 3. Ownership Document – Notarised copy of regist ered document

(registered by competent authority) by which r ig h t in immovable property has been acquired (E.g. sale deed, g i ft deed, succession deed, partition deed, Inventory P roceedingsJudgement and Order, Court order, Lease deed, etc.)


Page 10

1. Application on plain paper. 2. Certificate of Freedom Fighter (Registere d with

secretariat) (attested/notarized). 3. Birth Certificate of the Applicant. 4. Identity proof of the Applicant e.g. Voter’s card , PAN

card, Driving Licence, Passport copy, Aadhar card et c . (Any one)

5. Marriage Certificate (incase of married woman). 6. Self Declaration.




Page 39



XXIII. NEW RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Prescribed Form ‘C’. 3. Original Cancellation certificate. 4. House Tax Receipt/ Electricity bill/ water bi ll.(Original or Self At-

tested Xerox).

5. If rental, N. O. C. on self declaration of house o w ner along with photo Identity of Owner.

6. Self declaration of Applicant. 7. Marriage Certificate. (incase of woman - married and shifted) (Self

Attested).

8. Children- Birth Certificate (For children above 5 years – Bonafide certificate). (Self Attested).

9. Aadhar card (if not available) than any other Pho t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passport c o py, etc. (Self Attested).

XXIV. SEPARATE RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Prescribed Form ‘C’. 3. House Tax Receipt /Electricity bill/ water bi l l. (Original or Self At tested

Xerox).

4. Self declaration of Applicant. 5. Old Ration Card Copy existing. (Self Attested).

6. Aadhar card (if not available) than any other Pho t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passpo r t copy, etc. (Self Attested).

XXV. NAME INCLUSION IN RATION CARD

1. Application by Head of Family with Rs.5/- court f ees stamp. 2. Original Cancellation certificate. 3. Birth certificate + (For children above 5 yea r s – Bonafide certificate).

(Self Attested).4. Self declaration of person whose name to be inclu ded or Head of Family

(incase of inclusion of minor). 5. Aadhar card (if not available) than any other Pho t o identity card e.g.

Voter’s card, PAN card, Driving Licence, Passport co p y, etc. (Self At-tested).

6. Marriage certificate. (Incase of Married woman). (Self Attested).

Page 11Page 38



XXVI. NAME CORRECTION IN RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Birth certificate. (Self Attested).

3. Marriage certificate. (Self Attested).

4. Self declaration of the person whose name is to b e corrected or Head of Family (incase of correction of minor).

5. Aadhar card (if not available) than any other Ph o t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passport copy, etc. (Self Attested).

XXVII. DUPLICATE RATION CARD

1. Application by Head of Family with Rs.5/- court fees stamp. 2. Original Missing report from Police Station. 3. Original Fair Price Shop certificate. 4. Self declaration of Head of Family. 5. Ration card Xerox copy (if any). (Self Attested).

XXVIII. CANCELLATION CERTIFICATE

1. Application by applicant with Rs.5/- court fees stamp. 2. Original ration card.

(Note: Those cancelling due to Portuguese citizensh ip (Passport) shall furnish additional documents as follows :

3. Portuguese Passport copy notarised. 4. Xerox copy of ration card. (Self Attested).



Page 12 Page 37


Page 13Page 36

....................................................15

............................................................15

................................................15

............................................16

............................................................16

................................................................................16

....................................................................................17

....................................................................................17

...........................................................................................17

.................................................18

................................................18

...................................................19

.....................................................................................19

.................................................................20

...............................................................................20

...............................................................................................21

.............................................22


Page 14 Page 35

....................................................23

............................................................................24

......................24

....................................25

.................................................................................25

...................................................................................26

.........................................26

..................................................................................................27

.........................................................................................28

..........................................................................28

..................................................................29

.....................................................................29

.................................................................................30

...........................................30

1.

2.


Page 15Page 34


Page 16 Page 33


Page 17Page 32

......................................................................................41

..............................................................................42

..................................................................................................42

...................................................................................................43

..............................................................................43

...............................................................................................44

............................................45

..................................................................................................45

.........................................................................................46

........................................................................46

.....................................................47

.................................................................47

.................................................................................48

.......................................48


Page 18 Page 31

......................................................33

..............................................................33

....................................................33

.....................................................34

...................................................................34

....................................................................................34

.........................................................................................35

........................................................................................35

.................................................................................................35

...................................36

.........................................36

......................................................37

..............................................................37

............................................................................38

.....................................................................................39

.................................................................................................39

.....................................40

1.

2.


Page 19 Page 30


Page 20 Page 29

+


Page 21 Page 28


Page 22 Page 27


Page 23 Page 26


Page 24 Page 25


Page 23 Page 26


Page 22 Page 27


Page 21 Page 28


Page 20 Page 29

+

1.

2.


Page 19 Page 30


Page 18 Page 31

......................................................33

..............................................................33

....................................................33

.....................................................34

...................................................................34

....................................................................................34

.........................................................................................35

........................................................................................35

.................................................................................................35

...................................36

.........................................36

......................................................37

..............................................................37

............................................................................38

.....................................................................................39

.................................................................................................39

.....................................40


Page 17Page 32

......................................................................................41

..............................................................................42

..................................................................................................42

...................................................................................................43

..............................................................................43

...............................................................................................44

............................................45

..................................................................................................45

.........................................................................................46

........................................................................46

.....................................................47

.................................................................47

.................................................................................48

.......................................48


Page 16 Page 33


Page 15Page 34


Page 14 Page 35

....................................................23

............................................................................24

......................24

....................................25

.................................................................................25

...................................................................................26

.........................................26

..................................................................................................27

.........................................................................................28

..........................................................................28

..................................................................29

.....................................................................29

.................................................................................30

...........................................30

1.

2.


Page 13Page 36

....................................................15

............................................................15

................................................15

............................................16

............................................................16

................................................................................16

....................................................................................17

....................................................................................17

...........................................................................................17

.................................................18

................................................18

...................................................19

.....................................................................................19

.................................................................20

...............................................................................20

...............................................................................................21

.............................................22



XXVI. NAME CORRECTION IN RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Birth certificate. (Self Attested).

3. Marriage certificate. (Self Attested).

4. Self declaration of the person whose name is to b e corrected or Head of Family (incase of correction of minor).

5. Aadhar card (if not available) than any other Ph o t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passport copy, etc. (Self Attested).

XXVII. DUPLICATE RATION CARD

1. Application by Head of Family with Rs.5/- court fees stamp. 2. Original Missing report from Police Station. 3. Original Fair Price Shop certificate. 4. Self declaration of Head of Family. 5. Ration card Xerox copy (if any). (Self Attested).

XXVIII. CANCELLATION CERTIFICATE

1. Application by applicant with Rs.5/- court fees stamp. 2. Original ration card.

(Note: Those cancelling due to Portuguese citizensh ip (Passport) shall furnish additional documents as follows :

3. Portuguese Passport copy notarised. 4. Xerox copy of ration card. (Self Attested).



Page 12 Page 37



XXIII. NEW RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Prescribed Form ‘C’. 3. Original Cancellation certificate. 4. House Tax Receipt/ Electricity bill/ water bi ll.(Original or Self At-

tested Xerox).

5. If rental, N. O. C. on self declaration of house o w ner along with photo Identity of Owner.

6. Self declaration of Applicant. 7. Marriage Certificate. (incase of woman - married and shifted) (Self

Attested).

8. Children- Birth Certificate (For children above 5 years – Bonafide certificate). (Self Attested).

9. Aadhar card (if not available) than any other Pho t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passport c o py, etc. (Self Attested).

XXIV. SEPARATE RATION CARD

1. Application by applicant with Rs.5/- court fees stamp. 2. Prescribed Form ‘C’. 3. House Tax Receipt /Electricity bill/ water bi l l. (Original or Self At tested

Xerox).

4. Self declaration of Applicant. 5. Old Ration Card Copy existing. (Self Attested).

6. Aadhar card (if not available) than any other Pho t o identity card e.g. Voter’s card, PAN card, Driving Licence, Passpo r t copy, etc. (Self Attested).

XXV. NAME INCLUSION IN RATION CARD

1. Application by Head of Family with Rs.5/- court f ees stamp. 2. Original Cancellation certificate. 3. Birth certificate + (For children above 5 yea r s – Bonafide certificate).

(Self Attested).4. Self declaration of person whose name to be inclu ded or Head of Family

(incase of inclusion of minor). 5. Aadhar card (if not available) than any other Pho t o identity card e.g.

Voter’s card, PAN card, Driving Licence, Passport co p y, etc. (Self At-tested).

6. Marriage certificate. (Incase of Married woman). (Self Attested).

Page 11Page 38



XX. CERTIFICATE OF DEPENDENCY (Incase of Surviving and old aged dependants)

1. Application on plain paper. 2. Birth Certificate of the Applicant (Self Attested). 3. Identity proof of the Applicant e.g. Voter’s card , P AN card,

Driving Licence, Passport copy, Aadhar Card, etc.( Any one) (Self Attested).

4. Self Declaration of the Applicant. 5. Self Declaration of the Dependant.


XXI. CERTIFICATE FOR UNEMPLOYED CHILDREN OF FREEDOM FIGHTERS


XXII. MUTATION

1. Application with Rs.5/- court fees stamp. 2. Form I and XIV (original). * 3. Ownership Document – Notarised copy of regist ered document

(registered by competent authority) by which r ig h t in immovable property has been acquired (E.g. sale deed, g i ft deed, succession deed, partition deed, Inventory P roceedingsJudgement and Order, Court order, Lease deed, etc.)


Page 10

1. Application on plain paper. 2. Certificate of Freedom Fighter (Registere d with

secretariat) (attested/notarized). 3. Birth Certificate of the Applicant. 4. Identity proof of the Applicant e.g. Voter’s card , PAN

card, Driving Licence, Passport copy, Aadhar card et c . (Any one)

5. Marriage Certificate (incase of married woman). 6. Self Declaration.




Page 39



XVII. INCOME CERTIFICATE ISSUED ONLY FOR MEDICLAIM

1. Application in prescribed form with Rs.5/- C o u r t fees stamp.

2. Birth Certificate. 3. School Leaving Certificate.

4. Voter’s Card. 5. Doctor’s Certificate. 6. Marriage Certificate (incase of married woman). 7. Ration card copy. 8. Original Income certificate from C.C.P./Village P a nchayat/

Municipality. 9. Self declaration stating the no. of family membe r s , part

no., sr. no., constituency no. and name on the elect o r a l roll published in the current year.


XVIII. INCOME CERTIFICATE ISSUED ONLY FOR SPORTSPERSON

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth / School Leaving Certificate. 3. Marriage Certificate (incase of married woman). 4. Letter from Sports Authority of Goa issued to th e applicant. 5. Identity proof of the Applicant e.g. Voter’s card , PAN card,

Driving Licence, Passport copy, Aadhar card etc. (Any one) 6. Original Income certificate from C.C.P./Village P a nchayat/

Municipality.


X X. CERTIFICATE OF DEPENDENCY I (Incase of death).

1. Application on plain paper. 2. Death Certificate (attested/notarized). 3. Birth Certificate of the Applicant and ot h e r children

including married daughter. 4. Identity proof of the Applicant e.g. Voter’s car d , P A N

card, Driving Licence, Passport copy, Aadhar card et c . (Any one).

5. Marriage Certificate (if any) (incase of married woman). 6. Deed of Succession, Inventory Proceedings (if any)

(attested/notarized) 7. Self Declaration.


Page 9

Self Attested

Copies

(Sr. No. 2—7 )

Self Attested

Copies

(Sr. No. 3—5 )

Page 40

Self Attested

Copies

(Sr. No. 2—5)



XV. RESIDENCE CERTIFICATE

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth Certificate. 3. Residence Certificate (old copy, if any). 4. Educational qualification certificate.(School L eaving or

Bonafide Certificate) 5. Identity proof e.g. Voter’s card, PAN card, Driv i n g

Licence, Passport copy, Aadhar card etc. (Any one) 6. Marriage Certificate (Incase of married woman). 7. LPG Connection (Incase of rented premises). 8. Self Declaration. 9. Self Declaration (N. O. C.) of the house owner ( I n c a se of

rented premises). 10. 2 Photos (Passport size).

Note: Those applying for the purpose of Portuguese Passport shall furnish additional documents as follows:

11. Indian Passport copy (Self attested Xerox copy). 12. While collecting certificate— 1 govt. witne s s ’ s signature

along with name and designation and name of office.


XVI. DIVERGENCE CERTIFICATE

1. Application in prescribed form with Rs.5/- Court fees stamp. 2. Birth Certificate. 3. School Leaving Certificate. 4. Voting Card/Aadhar card (only as Identity proof). 5. Marriage Certificate (Incase of married woman) (if any). 6. Passport Copy (not compulsory). 7. Self Declaration. 8. If Govt. employee – Service book, pension book/ or d er (Self

Attested).


Page 8


Page 41




XII. PARTITION

1. Application with Rs.5/- court fees stamp. 2. Form I and XIV (1 original + 1 attested / notarised) *

3. Site plan i.e. plan showing the area to be partitioned (1 original +1 Xerox). 4. Survey Plan ( 1 original + 1 Xerox). 5. Title / Ownership documents e.g. Sale deed etc. (1 notarised/attested + 1 Xerox).

XIII. CONVERSION

*Note: Area less than 500 sq. meters application to be made to the Dy. Collector and SDO. Area more than 500 s q. meters application to be made to the Collector .

1. Application in prescribed form with Rs.5/- court fees stamp. 2. Form I & XIV (1 original + 4 Xerox copies). *3. Survey plan ( 1 original + 4 Xerox copies). 4. One Notarized Copy of Sale Deed etc. and 4 Xerox copies of

the deed. 5. Site plan on the basis of Survey plan ( 1 original + 4 Xerox copies). 6. Manual copy of Form I & XIV maintained by the Talathi’s office.

XIV. SOUND PERMISSION UPTO 10 P. M.

1. Application in prescribed form. 2. Permission of Land owner. 3. Permission of Local Authority ( C.C.P. / Villa g e Panchayat /

Municipality) 4. Incase of Wedding – Wedding card/Booking receip t o f the

place / N.O.C from hall. 5. Incase permission needed on beach – N.O.C. from C RZ and

Tourism Department. 6. In case permission needed on vehicle then applic a n t to

specify the vehicle numbers along with attested Xerox copies of Registration of Certificate (R. C.) book.

Page 7



Page 42





X. OBC CERTIFICATE

1. Application in prescribed form along with a photo a ttached and Rs.5/- court fees stamp.

2. Birth certificate of the applicant (Self Attested). 3. Birth certificate of applicant’s father or a n y r latives from e

father’s side (Self Attested). 4. Applicant’s school leaving certificate or bonaf d e certificate i

issued by school authorities (Self Attested). 5. Documents showing that applicant’s father or gra n d father

belong to OBC notified by Government (Self Attested). 6. Document showing that the applicant/ applicant’s father was

residing in Goa prior to 19/02/1968 (Self Attested). 7. Self Declaration. 8. Samaj certificate (Self Attested). 9. Income certificate issued by the competent authority for

preceding 3 years. (Village Panchayat / Municipality / C.C.P.) (Original).

10. Talathi’s report along with report of t h e concerned Mamlatdar (Original).

11. Marriage certificate in case of marr i e d w o man (Self Attested).


XI. RENEWAL OF OBC CERTIFICATE

1. Application in prescribed form along with a phot o a ttached and Rs.5/- court fees stamp.

2. A copy of social status certificate (caste certif i c a te) issued earlier by the concerned Dy. Collector a n d S DO. (Self Attested).

3. Fresh income certificate issued by the compete n t authority for preceding 3 years. (Village Panchayat / Municip a l i t y / C.C.P.) (Original).

4. Confirmation letter of the social status certifi c a te issued to the applicant by the Director of Soci a l W e l fare (Self Attested).


Page 6 Page 43

5


IX. SC/ST CERTIFICATE

1. Application in prescribed form along with a photo attached and Rs.5/- court fees stamp.

2. Birth certificate of the applicant (Self Attested). 3. Birth certificate of applicant’s father or any relatives from

father’s side (Self Attested). 4. Applicant’s school leaving certificate and bonafi d e certificate

issued by school authorities (Self Attested). 5. Documents showing that applicant’s father or gra n d f ather

belong to SC/ST notified by Government (Self Attested). 6. Documents showing that applicant / applicants Family w a s

residing in Goa prior to 19/02/1968 (Self Attested). 7. Self Declaration. 8. Samaj certificate (Self Attested). 9. Talathi’s report along with report of the concern ed Mamlatdar

(Original). 10. Marriage certificate for married woman (Self Attested). 11. Additional 2 photo’s of applicant (Passport size). 12. Aadhar card/Voter’s card (if any) (Self Attested).

*Note: No Income Certificate is required for ST/SC certificates.

Page 5


Page 44


III. REFUND OF STAMP PAPER

1. Application for refund on plain paper. 2. Original stamp papers. 3. Challan from Vendor. 4. Vendor’s certificate. 5. TR 41 form and Bank details form (prescribed form).

IV. REFUND OF FRANKING

1. Application for refund on plain paper. 2. Original franking papers. 3. Challan from bank. 4. Original payment slip. 5. Confirmation letter from bank. 6. TR 41 form and bank details form (prescribed form).

V. REFUND OF COURT FEE

1. Application for refund on plain paper. 2. Original Refund Certificate from Court. 3. Challan from Vendor. 4. TR 41 form and bank details form (prescribed form).

Page 4


VI. ADJUDICATION OF FOREIGN POWER OF ATTORNEY (P.O.A)

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of POA. 3. Special adhesive stamp of Rs.500/- (in case P O A is given for

transfer of Property by sale etc. ) ( In all o the r cases Special adhesive stamp of Rs.100/-)

4. Identity proof /address proof of attorney holde.r (e.g. Voter’s card, PAN card, Driving Licence, Passport, etc.)


VII. ADJUDICATION OF FOREIGN BIRTH/DEATH/MARRIAGEC E R TIFICATE/ DIVORCE CERTIFICATE/BAPTISM CERTIFICATE

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of the relevant certificate.

(Foreign Birth/ Death/ Marriage Certificate/ Divorce Certificate/ Baptism Certificate).


VIII. ADJUDICATION OF AFFIDAVIT

1. Application for adjudication on plain paper. 2. Original and one Xerox copy of the Affidavit. 3. Special adhesive stamp of Rs.50/-


Page 45



I. DOMICILE CERTIFICATE

1. Application in prescribed form. 2. Birth Certificate. 3. Residence Certificate (preceding 5 years). 4. Educational qualification certificate. 5. Identity proof e.g. Voter’s card, PAN card, D rivin g

License, Passport copy, Aadhar card, etc.(Any one). 6. 2 Photos (Passport size). 7. Affidavit on Rs.50/- stamp paper. 8. Prescribed processing fees.

II. ARMS LICENCE

(A) For self protection

1. Application in prescribed form. 2. Birth Certificate. 3. Identity proof e.g. Voter’s card, PAN card, D r iving

Licence, Passport copy, etc. (Any one). 4. Income Tax returns of last 3 years. 5. Business Registration certificate (if any). 6. 3 Photos (Passport size). 7. Audited Statement for preceding financial year (X erox

Copy). 8. Prescribed processing and License fees.


(B) For crop protection

1. Application in prescribed form. 2. Birth Certificate. 3. Identity proof e.g. Voter’s card, PAN card, Dri v in g

Licence, Passport copy, etc. (Any one). 4. Original Form I and XIV (latest copy). 5. 3 Photos (Passport size). 6. Prescribed processing and License fees.


Page 3

Self Attested Copies

(Sr. No. 2—5 )


Copies

(Sr. No. 2—5 )


Copies

(Sr. No. 2 & 3 )

(C) Renewal of Arms Licenses (Self and Crop Protection)

1. Application in prescribed form. 2. Original Arms License. 3. Prescribed processing and License fees.

Page 46


Index


XV. RESIDENCE CERTIFICATE.....................................................8

XVI. DIVERGENCE CERTIFICATE..................................................8

XVII. INCOME CERTIFICATE ISSUED ONLY FOR MEDICLAIM............9

XVIII. INCOME CERTIFICATE ISSUED ONLY FOR SPORTSPERSON....9

XIX. CERTIFICATE OF DEPENDENCY (Incase of death)....................9

XX. CERTIFICATE OF DEPENDENCY (Incase of Surviving and old aged dependants)...............................................................10

XXI.CERTIFICATE FOR UNEMPLOYED CHILDREN OF FREEDOM FIGHTERS......10

XXII. MUTATION.......................................................................10


XXIII. NEW RATION CARD.........................................................11

XXIV. SEPARATE RATION CARD................................................ 11

XXV. ................................. 11 NAME INCLUSION IN RATION CARD

XXVI. NAME CORRECTION IN RATION CARD................................12

XXVII. DUPLICATE RATION CARD..............................................12

XXVIII. CANCELLATION CERTIFICATE.........................................12



Page 2 Page 47

K onkani Pages 13 to 30

M arathi Pages 31 to 48


Index


I. DOMICILE CERTIFICATE....................................................... 3

II. ARMS LICENCE....................................................................3 (A) For self protection (B) For crop protection (C) For Renewal of Arms License

III. REFUND OF STAMP PAPER...................................................4

IV. REFUND OF FRANKING........................................................4

V. REFUND OF COURT FEE......................................................4

VI. ADJUDICATION OF FOREIGN POWER OF ATTORNEY (P.O. A)....4

VII. ADJUDICATION OF FOREIGN BIRTH / DEATH / MARRIA GE CERTIFICATE/ DIVORCE CERTIFICATE/BAPTISM CERTIFICATE..4

VIII. ADJUDICATION OF AFFIDAVIT..........................................4


IX. SC/ST CERTIFICATE.........................................................5

X. OBC CERTIFICATE...........................................................6

XI. RENEWAL OF OBC CERTIFICATE........................................6

XII. PARTITION.....................................................................7

XIII. CONVERSION.................................................................7

XIV. SOUND PERMISSION UPTO 10 P. M...................................7

Page 1


Page 48

1.

2.