Indigenous Nationalities Registration Form

पहिलो नाम *:

बीचको नाम:

थर :

First Name *:

Middle Name:

Last Name:

Contact No. *:

Gender *:

Male Female Others

आदिवासी जनजाति समूह :

बुबाको/पतिको नाम:

आमाको नाम:

जन्म मिति:

Citizenship Number *:

Indigenous Nationalities Group *:

Father/Husband Name *:

Mother's Name *:

Date of Birth:

प्रदेश: *:

जिल्ला:

नगरपालिका /गा.पा.:

टोल:

वडा नं.:

Province *:

District *:

Municipality/ VDC:

Tole:

Ward No.:

Indigenous Nationalities Recommendation Letter from related organization or ward office(any one):
(आदिवासी जनजाति सिफारिस पत्र)

Photo:
(Passport Size )

(In .jpg Format)

Citizenship Front:
ना.प्र.प

(In .jpg Format)

Citizenship Back:
ना.प्र.प

(In .jpg Format)

Submission Date :

Signature:
हस्ताक्षर

(In .jpg Format)

If Infant: (नाबालकको हकमा)

Birth Certificate :
जन्मदर्ता

(In .jpg Format)

Father's Citizenship Photo :
बुबाको ना.प्र.प

(In .jpg Format)

If married to Indigenous Nationality: (आदिवासी जनजातिसँग बिहे भएमा)

Marriage Certificate :
विवाह प्रमाणपत्र

(In .jpg Format)

Husband's Citizenship :
पतिको ना.प्र.प

(In .jpg Format)

Valid Email *:
(This email is used for sending indigenous nationalities certificate when your form submission is approved)

Password:

Confirm Password:

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The payment can be made after you fill up all the form details. Thank you.
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