| Is your present address out of India? |
Select Yes, if your present address is outside India, else select No. |
| Residing Since (Month/YYYY) |
Click the dropdown list to select the month, and in the text box enter the year (E.g. 1965) since when you are residing at your present address. |
| House No and Street Name |
Enter house number and street name of your present address. |
| Village/ Town/ City |
Enter name of village/ city/ town of your present address. |
| State/ UT |
Enter name of the state or union territory in which your village/ town/ city is located. |
| District |
Enter name of the district in which your village/ town/ city is located. |
| Police Station |
Enter name of the police station under jurisdiction of which your present address is located. |
| PIN Code |
Enter the PIN code of your present address. |
| Mobile Number |
Enter your Mobile no. |
| Telephone Number |
Enter landline telephone number, including country and area code, on which you can be contacted. |
| E-mail ID |
Enter email ID at which messages can be sent to you. |
| Is your permanent address same as present address? |
Select Yes, if your current address and permanent address are same, else select No. |