pnd digisignpnddigisign.com/class3a_individual.pdf · [attestation by the gazetted officer (list...

PND DIGISIGN 103, 1 st Floor, Simandhar, Wamanrao Sawant Road, Opp. Jana Seva Bank, Dahisar (E), Mumbai – 400068. Tel: (022) 28284033 / 28282998 / 98209 44649 Email: [email protected] website: www.pnddigisign.com INSTRUCTIONS / CHECKLIST 1. Please fill the form in BLOCK LETTERS & in BLUE INK ONLY 2. The Certificate will be issued only if the application form is complete in all aspects. 3. Along with the completed and signed application form, please attach following documents as mentioned below: Attachments Document 1 An attested copy of PAN If PAN Card is not available, submit Copy of Latest Income Tax Return along with Photo Identity proof as listed on last page of the form. Document 2 An attested copy of proof of address any one from listed on last page. In case of any utility bills like electricity, water, gas, and telephone bill, & Bank Statement should not be older than 3 months from the date of application. [Attestation by the Gazetted Officer (List attached) / Bank Manager / Post Master), details of the attesting officer like name, designation, branch address and branch landline contact no. should also be mentioned. Signature of Attesting Officer in BLUE INK ONLY]. Latest Photograph of the Applicant to be pasted and Signed across. 4. Unique Email Address & Mobile Number is mandatory. 5. Mobile verification (Tele-Verification) to be done by applicant after processing of application. (If due to any reason mobile/tele-verification fails then Original Application will not be given back as it will be submitted to company. Even amount will not be refunded.) 6. The authentication credentials to download the DSC would be sent through SMS ONLY on the Applicants Mobile Number. 7. Video Verification: In case of Class 3, video verification is mandatory List of Group ‘A’ /Group ‘B’ Gazetted officers Group ‘A’ Gazetted officers include i) All India services though posted to states ii) Promotes from states to the cadre of Assistant commissioner and above iii) Police officers (Circle Inspector and above) iv) Additional District Civil surgeons v) Executive Engineers and above vi) District Medical Officer and above vii) Lt. Col and above viii) Principals of Government Colleges and above ix) Readers and above of Universities x) Patent Examiner etc. Group ‘B’ Gazetted officers include i) Section Officer ii) BDO(Block Development Officer) iii) Tahsildar iv) Junior Doctors in Government Hospitals v) Assistant Executive Engineer vi) Lectures in Government colleges vii) Headmaster of Government high schools viii) 2nd Lieutenant to Major ix) Magistrate (Notary & SEO Attestation will not acceptable)

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Page 1: PND DIGISIGNpnddigisign.com/Class3A_Individual.pdf · [Attestation by the Gazetted Officer (List attached) / Bank Manager / Post Master), details of the attesting officer like name,

PND DIGISIGN103, 1st Floor, Simandhar, Wamanrao Sawant Road, Opp. Jana Seva Bank, Dahisar (E), Mumbai – 400068.

Tel: (022) 28284033 / 28282998 / 98209 44649 Email: [email protected] website: www.pnddigisign.com

INSTRUCTIONS / CHECKLIST

1. Please fill the form in BLOCK LETTERS & in BLUE INK ONLY

2. The Certificate will be issued only if the application form is complete in all aspects.

3. Along with the completed and signed application form, please attach following documents as mentioned below:

Attachments

Document 1 An attested copy of PAN If PAN Card is not available, submit Copy of Latest Income TaxReturn along with Photo Identity proof as listed on last page of the form.

Document 2 An attested copy of proof of address any one from listed on last page.

In case of any utility bills like electricity, water, gas, and telephone bill, & Bank Statementshould not be older than 3 months from the date of application.[Attestation by the Gazetted Officer (List attached) / Bank Manager / Post Master), details ofthe attesting officer like name, designation, branch address and branch landline contact no.should also be mentioned. Signature of Attesting Officer in BLUE INK ONLY].Latest Photograph of the Applicant to be pasted and Signed across.

4. Unique Email Address & Mobile Number is mandatory.

5. Mobile verification (Tele-Verification) to be done by applicant after processing of application.(If due to any reason mobile/tele-verification fails then Original Application will not be given back as itwill be submitted to company. Even amount will not be refunded.)

6. The authentication credentials to download the DSC would be sent through SMS ONLY on the ApplicantsMobile Number.

7. Video Verification: In case of Class 3, video verification is mandatory

List of Group ‘A’ /Group ‘B’ Gazetted officers

Group ‘A’ Gazetted officers includei) All India services though posted to statesii) Promotes from states to the cadre of Assistant

commissioner and aboveiii) Police officers (Circle Inspector and above)iv) Additional District Civil surgeonsv) Executive Engineers and abovevi) District Medical Officer and abovevii) Lt. Col and aboveviii) Principals of Government Colleges and aboveix) Readers and above of Universitiesx) Patent Examiner etc.

Group ‘B’ Gazetted officers includei) Section Officerii) BDO(Block Development Officer)iii) Tahsildariv) Junior Doctors in Government Hospitalsv) Assistant Executive Engineervi) Lectures in Government collegesvii) Headmaster of Government high schoolsviii) 2nd Lieutenant to Majorix) Magistrate

(Notary & SEO Attestation will not acceptable)

Page 2: PND DIGISIGNpnddigisign.com/Class3A_Individual.pdf · [Attestation by the Gazetted Officer (List attached) / Bank Manager / Post Master), details of the attesting officer like name,

PND DIGISIGN103, 1st Floor, Simandhar, Wamanrao Sawant Road, Opp. Jana Seva Bank, Dahisar (E), Mumbai – 400068.

Tel: (022) 28284033 / 28282998 / 98209 44649 Email: [email protected] website: www.pnddigisign.com

Please make payment by Demand Draft in the favour of “PND DIGISIGN” or you can makepayment by NEFT (Ask for Bank Details) and send the receipt of NEFT along with this form.

COST STRUCTURE OF KIT AS FOLLOWS:

TYPE DSC +SERVICE

USBTOKEN

(ePass 2003 Auto)

USBTOKEN(Safenet)

DRIVERS/SOFTWARE

MRP(2 YEAR

VALIDITY)KIT 3 √ √ √ 5000/-

Provide your GST Details for BillingCompany Name

Company Address

GST No

PAYMENT DETAILSIssue DD in favour of “PND DIGISIGN”Name of the applicant: _______________________________________________________________