| 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 your house number and street name. |
| Village/ Town/ City |
Enter name of the village/ town/ city in which your house is located. |
| State (If in India) |
Enter name of the state or union territory in which your village/ town/ city is located, if present address is in India. |
| District (If in India) |
If your permanent address is in India, 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 address is located. |
| PIN Code |
Enter PIN code of the area in which your house is located. |
| Mobile Number |
Enter mobile number, if any, on which you can be contacted. |
| Telephone Number |
Enter landline telephone number, if any, 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. |