Barnia SKUS Ltd. | Samabay Krishi Unnayan Samiti

Full Name *

Father/Husband Name *

Date of Birth *

Gender *

Caste *

Religion *

Occupation

Annual Income (Rs)

Educational Qualification *

Mobile Number *

Village / Street *

Post Office *

Police Station *

District *

State *

Pin Code *

Mouza	Khatian No	Dag No	Area (Dec)	Classification	Action

Nominee Name *

Relationship *

Nominee DOB

Guardian (If Minor)

Applicant Photo *

Signature *

I am a citizen of India and ordinarily resident of the area of operation of the Society.
I undertake to abide by the West Bengal Co-operative Societies Act, 2006.

I confirm details are true.

Barnia Samabay Krishi Unnayan Samiti Ltd.