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DSC Application Form

This document is a request form for an individual to apply for a Class 2 digital certificate from Tata Consultancy Services Limited. It requests information such as name, gender, email addresses, identification and residential addresses, and requires the applicant to submit identity and residence documents like a passport, PAN card, or driver's license. The applicant must declare that they have read and understood the instructions, and the RA officer must verify and declare that they have received and verified the applicant's documents. The completed form and supporting documents must be mailed to the specified RA office address.

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Neelam Goel
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43 views2 pages

DSC Application Form

This document is a request form for an individual to apply for a Class 2 digital certificate from Tata Consultancy Services Limited. It requests information such as name, gender, email addresses, identification and residential addresses, and requires the applicant to submit identity and residence documents like a passport, PAN card, or driver's license. The applicant must declare that they have read and understood the instructions, and the RA officer must verify and declare that they have received and verified the applicant's documents. The completed form and supporting documents must be mailed to the specified RA office address.

Uploaded by

Neelam Goel
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TATA CONSULTANCY SERVICES LIMITED CERTIFYING AUTHORITY


REQUEST FORM FOR CLASS 2 CERTIFICATE
INSTRUCTIONS
USER TYPE INDIVIDUAL

Validity of DSC* Gender* Male Female nmlkj nmlkj
gfedc
Empower India DSC
gfedc
1 year
gfedc
2 Years
Surname^ Given Name*^
Father/Husband's Name Initials^
E-Mail Address*^
Alternative E-Mail Address

Organization Details
Name
House Identifier
Street Address
City Pin Code
Country

6
State
Telephone Mobile
Residential address
House Identifier*^
Street Address*^
City*^ Pin Code*^
Country*^

6
State*^
Telephone* Mobile
DOCUMENT CHECKLIST FOR INDIVIDUAL TYPE OF CERTIFICATE
Subscriber proof of identity and residence(ATTESTED copy required)
gfedc
Identity and Residence
gfedc
Passport gfedc
Driving License
gfedc
Identity
gfedc
PAN Card gfedc
Passport
gfedc
Bank A/C Passbook with
Photo
gfedc
Driving License
gfedc
Photo Identity Card
gfedc
Residence
gfedc
Latest Telephone Bill gfedc
Latest Electricity Bill
gfedc
Latest Bank Statement gfedc
Passport
gfedc
Driving License



Applicant Declaration
I hereby confirm that I have read and understood the above instructions and will
follow the above instructions for obtaining and using the Digital Signature
Certificate.

Date:

Place: Signature of the Applicant
RA Declaration
I hereby confirm that I have received and verified the documents submitted by
the subscriber.


Date:

Place: Signature of the RA Officer
RA OFFICE NAME : ____________________ / USER ID : ______________ / REQUEST NUMBER :____________



Help
Please enter your PAN card
number as in the enclosed
attested copy of your PAN
Card. Eg. AAAAA1111A.
Maximum limit of 32
characters.
The certificate Request Form, Online Enrollment Form, Demand Draft and the supporting documents as per the document checklist have to be
forwarded to the following address:

Duly mark the envelope as 'APPLICATION FOR DIGITAL CERTIFICATE'


RA Office

_____________________________

_____________________________

_____________________________

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