NIC Certifying Authority

National Informatics Centre Photo & ID proof to

Ministry of Communications & Information Technology be attested by HO
Government of India
Ref. No. …….……………………
(To be filled by NICCA/RA Office)
DIGITAL SIGNATURE CERTIFICATE REQUEST FORM
NOTE:
1. READ INSTRUCTIONS FIRST. All fields are mandatory and validity of the filled form is 90 days.
2. Please Tick (√) the appropriate option & submit only Page No. 1 & 2 after filling.
3. Subscriber is advised to read Certificate Practice Statement of NICCA. Affix Recent
4. Validity period cannot exceed the date of superannuation of applicant. Passport size
5. Asterisk (*) mark entry will be used in Certificate Subject Details. Photograph
6. INCOMPLETE/INCONSISTENT FORMS WILL BE SUMMARILY REJECTED. Attested by HO

1. Category of Applicant : _____________________________ [Fill code from Annexure-I]

2. Project Code : _____________________________ [Fill code from Annexure-II]
3. Class of Certificate Required : Class-1 /Class-2 /Class-3 Device Required: No Device/Token/ Smart Card only for signing certificate
4. Certificate Required (Usage) : Signing /Encryption /SSL/System/Code Signing [Separate Form for each except Signing/Encryption]
5. Certificate Validity [Max. 2 Years] : Two Years /Specify Validity [if less than 2 Years] __________________________________________
6. Date of Superannuation [DD/MM/YYYY] : ___________________________________________________________________________________
7. Name* (in BLOCK letters only) : ___________________________________________________________________________________
8. Designation : ___________________________________________________________________________________
9. Email-id*[Official email-id preferred] : ___________________________________________________________________________________
10. Ministry/Department : ___________________________________________________________________________________
a) Office Address : ___________________________________________________________________________________
___________________________________________________________________________________
Tel. No.(O)*___________________________ Mobile No.* __________________________________

b) Residential Address : ___________________________________________________________________________________

11. Identification Details : ___________________________________________________________________________________

[Attach a photocopy of [Departmental / Employment Photo ID No./ Service Verification Certificate with photograph on
the same attested by HO ] official letter head]

12. Certificate Subject Details* : Organisation* _______________________________________________________________________

Organisation Unit* ___________________________________________________________________
City* _________________________________________ Postal Code*__________________________
State* _________________________________________Country* INDIA
* *
Only for PAN enabled DSC : PAN No. ____________________________________ [Attach a self attested photo copy of PAN card,
for Company PAN enabled DSC: provide a company PAN & documentary proof for holding position
in the company]

13. SSL/Web Server Certificate Details : Public IP Address____________________________ Physical Location ________________________
[To be filled only for SSL certificate] URL/Domain Name _________________________________________________________________
Alternate Domain Name ______________________________________________________________
IP allocation Organisation_____________________________________________________________

14. System Certificate Details : IP Address________________________MAC Address _____________________________________

[Any one detail required] Serial No./Unique Id (CPU/device)______________________________________________________

15. Payment Details : DD No. _________________ Date _______________Bank Name_____________________________

NICSI Project No., if any _____________________________________________________________

Place: ……………………
Date: …………………….. (Please do not write below this line) [Signature of Applicant]
(For NICCA/RA Office Use Only)
Req. No. (S)_________________________
REF SCAN UID SC/SCR TKN PRN Req. No. (E)_________________________
RAA Name …………………………….. Date ……………...

[Version: DSC Form V 6.2 (Doc-Id. Form-1) Updated on: 25 June 2014] Page 1
Declaration by Subscriber
I hereby declare and understand that
1. I have read the subscriber agreement under Resource link available on NICCA website (https://nicca.nic.in).
2. I shall keep the private key safe on FIPS-140 Level-2 compliant smart card/USB crypto-tokens (Signing/Code Signing certificate) and will
not share with others.
3. I shall verify the contents and the correctness of the certificate before accepting the DSC. I shall send a signed mail to NICCA
([email protected]) to acknowledge the acceptance of the DSC.
4. I shall not use the private key before acceptance of the DSC.
5. I authorize NIC-CA to publish the certificate in the NIC-CA repository after acceptance of the DSC.
6. If the private key of my DSC is compromised, I shall communicate to NICCA without any delay as per the requirement mentioned
in Regulation 6 of Information Technology (Certifying Authority) Regulation 2001.
7. I understand the terms and conditions of issued DSC and will use the DSC under the terms of issue as in the Certificate Practice Statement.
8. I understand that on cessation of my employment, I shall inform NICCA and my present employer for revocation of my Digital Signature
Certificate.
9. I am solely responsible for the usage of these Certificates/Tokens/ Technology. I shall not hold NICCA responsible for any data loss/ damage,
arising from the usage of the same.
10. I am aware that Key Escrow/Archiving of Encryption Keys is not done by NICCA and I shall not hold NICCA responsible or approach
NICCA for recovery of my private Encryption Key, in case of its loss or otherwise. I understand that in case of loss of private key of
encryption certificate, I will not be able to decrypt the data which was encrypted by corresponding public key of the encryption
certificate. I would keep safely backup of p12/pfx encryption key file and recover/restore the same in case its accidental or otherwise loss.
11. I shall be responsible for compliance to the relevant sections of the IT Act/Indian Telegraphic Act and other Acts/laws of the Indian legal system,
pertaining to Encryption/Decryption of any message or document or electronic data, and I shall be liable for associated penal actions, for any
breaches thereof.
12. NICCA shall not be held responsible and no legal proceeding shall be taken against NICCA for any loss and damage that may occur due
to any reason whatsoever including technology upgradation, malfunctioning or partial functioning of the software, USB Token/ Smart
Card or any other system.
13. I am aware that the Certificate, issued by NICCA is valid only for the intended usage and for the period mentioned in the certificate. I
undertake not to use the Certificate for any other purpose.
14. I am conversant with PKI technology, and understand the underlying risks and obligations involved in usage of Encryption Certificate/DSC.
15. For SSL Server Certificate, I undertake that I have checked the existence of IP/URL/domain name and physical location of the server.
16. For System Certificate, I undertake that MAC/Serial No./IP No. are correct and are in my custody.
17. For Class-3, certificate I shall appear in person at NICCA/RA/ Physical Appearance Centre (PAC) any of the NIC Centres, State Units/
District Centres/Cells at various Ministry Cell of NIC along-with a photograph and departmental photo-id card for verification.
I certify the following: (Tick whichever is applicable)
o I have not applied for a DSC with NIC-CA earlier.
o I have been issued a DSC by NICCA with User-id ___________________________which is Valid/Revoked/Suspended/Expired.
The information furnished above is true to the best of my knowledge and belief. I will comply with the terms and conditions of Subscriber (as in section
40-42 of the IT Act 2000) and those of the Certificate Practice Statement of the NIC-CA. If at a later stage any information is found to be incorrect or
there is non-compliance of the terms and conditions of use of the DSC, NIC-CA will not be responsible for the consequences/liabilities and will be free to
take any action including cancellation of the DSC.

Date:…………………….
Place:……………………. [Signature of Applicant]
Verification and/or Declaration by Head of Office of Applicant for issuance of DSC
1. This is to certify that Mr./Ms __________________________________has provided correct information in the Application form for issue of Digital
Signature Certificate for subscriber to the best of my knowledge and belief.
2. I have verified the credentials of the applicant as per the official records/I have got verification letter from the companies/vendors for the contractual
employees from where they have been hired/outsourced, as per the guidelines given at page 4.
3. I certify that contractual employee Mr/Ms. _________________________________is working in project __________________________________
at ___________________________________________________. His/her contract is valid from .............................. to ………….….……….
4. I hereby authorize him/her, on behalf of my organization to apply for obtaining DSC from NICCA for the purpose as in DSC.
5. In case of issuance of encryption certificate, it is further certified that a Policy/Procedure is in place, which describes the complete process for
Encryption Key Pair Generation, Backup Procedure, safe-keeping of Backups and associated Key Recovery Procedures. The consequences of loss of
the key have been explained to the user and he/she has been advised about securing the key and making it available to relevant authorities, in case of
emergency. I shall not approach NICCA for recovery of private Encryption Key, in case of its loss or otherwise.
6. For SSL server certificate, I have verified the existence of URL/IP, the IP allocation organisation and physical location of web server.
7. For System Certificate, I have verified the MAC/Serial/IP no of the system/device.
8. It is noted that the organization shall inform NICCA for revocation of DSC on the cessation/superannuation of his/her employment.
9. I have attested applicant’s photograph and the copy of the identification proof.

Date:
Place: [Signature of Officer with Office Seal with name and designation]
Note: Contractual employees will be issued only signing certificate and with a maximum validity of one year.
Checklist to be ticked [√] by NIC Coordinator before forwarding to NIC RA/CA Office
[ ] All asterisk (*) marked entries are filled [ ] Payment details filled & DD attached (if required)
[ ] Copy of Departmental photo-Id attested by HO/Service Verification [ ] Self attested copy of PAN card attached, if any
letter on letter head with photograph of the applicant
[ ] Signature of Applicant done [ ] Verification by Head of Office (HO) with Signature & Official Seal
[ ] In person verification is done for Class-3 applicant as attached Annexure-III [ ] Affixed photograph attested by the HO

Email:………………….............................. Mobile No.:………….………… [Signature of NIC Coordinator with name and designation/Office Seal]
Date: ______________________ Place:___________________________

[Version: DSC Form V 6.2 (Doc-Id. Form-1) Updated on: 25 June 2014] Page 2
 [This Form is to be forwarded to the respective RA/CA Office of NICCA]
[DETATCH PAGE NOs. 3 & 4 BEFORE SENDING THE DSC FORM]
Annexure-I
(Applicant Code & Category)
Code Category Code Category
1. Govt. 6. Contractual employee in the above category
2. Judiciary 7. MP/MLA
3. PSU 8. Elected Member of Village Panchayat/Gram Sabha
4. Statutory/Autonomous Body … …
5. Sec. 25 Company of Govt. 99. Others

Annexure-II
(Project Code & details)
Code Project Code Project
1. E-Procurement - NIC portal 21. Integrated Finance Management System
2. E-Tendering - NIC portal 22. Professional Courses Counselling, Admissions &
Results
3. E-Tendering - Others 23. Public Service Management System (Under the
Public Service Commission Act, MP)
4. E-Courts 24. e-FMS (Facility Management System Under the
MGNREGA)
5. Supply order placing/DGS&D 25. UP Technical Education Counselling
6. E-office 26. UP Polytechnic Counselling
7. Income Tax Return Filing 27. UP B.Ed counselling
8. Email authentication 28. UP Medical Counselling
9. Bhoomi Project 29. UP VAT (Commercial Tax)
10. E-District 30. SSDG/EDS
11. MNREGA 31. UP Education Department
12. Election Commission 32. Instant Money Order of Deptt of Posts
13. OASYS (Online Answering Information System 33. Online Police verification for passport
for Assembly Questions)
14. LRC (Land Record Computerization) 34. Mee Seva – Government of AP portal.
15. Treasury (for E-Payment) 35. ERMS Module - Portal for CEO, Tripura (Election
Commission)- private portal
16. Food & Civil Supplies (for Ration Cards) 36. Vat Soft for Taxes & Excise Organisation, Govt.
of Tripura
17. Nemmadi - Rural Digital Services 37. IVFRT
18. eAPAR 38.
19. Health department of Bangalore …
Mahanagara palike
20. Web HALRIS and Web HARIS 99. Others

A. Instructions for DSC Applicants

1. NIC-CA abides by the Information Technology Act, 2000, laid down by the Govt. of India. The applicant must read the IT Act 2000
under Resources (https://nicca.nic.in).
2. Subscriber is required to send one copy of DSC request form, duly signed and forwarded by Head of Office to respective RA/NIC-CA.
Applicant is advised to retain a copy of the same, which would be required while generating DSC request on line from
https://nicca.nic.in
3. The RA/NIC-CA scrutinizes the DSC form, for issue of DSC. If all particulars are in order, a User-Id, password and the profile for the
applicant is created using the details submitted. The form will be valid for 90 days only (applicant has to generate key pair request
and download certificate within 90 days) failing which, user is required to submit fresh DSC application.
4. It is very important & legally binding to keep the private key securely, for which the applicant must generate key pairs/request
using FIPS-140 Level-2 compliant smart card/USB crypto-tokens, which guarantees that private key never leaves the card/token
once generated.
5. In case of loss/compromise of DSC, applicant should immediately inform NIC-CA office either by phone 011-24366176 or e-mail at
[email protected] or send online revocation request through Member Login from https://nicca.nic.in.
6. For viewing all valid DSCs and CRLs, the user can access the website (https://nicca.nic.in/) under Repository.
7. Smart card/USB crypto-tokens, allow only maximum 4-10 numbers of incorrect attempts for entering pass phrase/pin. It is
advisable to be careful while entering the pass phrase as repeated incorrect entries shall block the same. On exceeding this limit,
special efforts may be required to unblock the device.
8. It is important to note that email-id given by the applicant is functional and applicant accesses the same on regular basis as all
communication related to DSC like generation, revocation, renewal, expiry details are communicated through the given email-id.

[Version: DSC Form V 6.2 (Doc-Id. Form-1) Updated on: 25 June 2014] Page 3
9. SSL Server certificates are not issued for Private IPs; it is issued only for Public IPs. The applicant has to fill the information about
IP address allocating Authority.

10. CERTIFICATE CLASSES, OID & ASSURANCE LEVEL

Sr. Class of OID Assurance Level/Verification Process
No. Certificate
1. Class-0 2.16.356.100.2.0 It carries no assurance, as it is created with general distinguished name not for an individual
2. Class-1 2.16.356.100.2.1 Provides minimum level of assurance. Subscriber’s identity is proved only with help of
Distinguished Name- DN and hence provides limited assurance of the identity.
3. Class-2 2.16.356.100.2.2 Provides higher level of assurance confirming the details submitted in the DSC Request
Form, including photograph and documentary proof in respect of at least one of the
identification details.
4. Class-3 2.16.356.100.2.3 Provides highest level of assurances, as verification process as in addition to the verification
process required for the class-2 certificates, the applicants are required to be personally
present at Physical Appearance Centre (PAC) for completion of in-person verification
process.
11. The DSC applicant with category Govt/PSU/Judiciary/Statutory/Autonomous Bodies/Sector 25 Govt Company has to get his
credentials verified from his/her Head of the office of organisation, contractual employee has to verify his credentials
from his/her employer, the Elected Member (MP/MLA/Village Panchayat/Gram Sabha) has to verify his/her credentials from
head secretariat/Panchayat.
12. For any further clarification, user can write to [email protected] or visit the NIC-CA website (https://nicca.nic.in).
13. Issued certificates not downloaded within 2 weeks shall be revoked without intimation to the applicant and a fresh form
would be required for new certificate.
14. Media provided by NICCA is with a warranty of six months against manufacturing defects from the date of issuance. In case of
manufacturing defect, the same shall be replaced, but for issuance of DSC, subscriber has to apply with a fresh form.
15. On loss/physical damage of USB Token/Smart Card, new media shall be issued after payment only. Also for issuance of new
DSC, the subscriber has to revoke the previous issued (lost) DSC and submit a new form for DSC issuance.
16. The media provided by NICCA shall provide support for platforms as mentioned at NICCA website (https://nicca.nic.in) Also
for platform which has become obsolete due to technology advancement, support shall be discontinued.
17. The applicant is responsible for preparation of his/her machine with all relevant software downloads from NICCA website or
otherwise for certificate request creation and download from web interface of NICCA at (https://nicca.nic.in).
18. Authentication pin for downloading the certificate shall be sent ONLY to the email specified in the DSC request Form. Request
for auth-pin from any other person will not be entertained. In case of accidental deletion/non-delivery of email containing
the pin the DSC applicant has to send a mail from email id quoted in the application to [email protected] for resending
the authentication pin.
19. Department photo-id card has to be produced for completion of physical verification for Class-3 DSC applicant.
20. Contractual employees will be issued only Class-1/Class-2 Signing certificates.
21. NICCA IS NOT RESPONSIBLE FOR ANY POSTAL DELAYS OR LOSS OCCURING DURING THE TRANSIT OF THE MEDIA. NICCA
CANNOT BE HELD LIABLE FOR THE SAME.

B. Guidelines for verification by Head of Office (HO)

The head of the office is appointed in the Govt. Department/Organisation. The Superior officer not necessarily be the
Head of the Office (HO).
a. The Head of Office (HO) of respective organizations/departments of DSC requestor has to verify the identity /credentials of
applicants. They will be solely responsible for authentication and validation of each subscriber/applicant within the organisation.
The onus of verification lies with Head of office (HO) of the Applicant.
b. For the DSC applicant with category Govt/PSU/Judiciary/Statutory/Autonomous Bodies/Sector 25 Govt Company the credentials
have to be verified by Head of the office of organisation, for the contractual employee credentials have to be verified by his/her
employer, for the Elected Member (MP/MLA/Village Panchayat/Gram Sabha) credentials have to be verified by secretary/
Panchayat Head.
c. The HO of respective organizations/departments must utilize various procedures to obtain evidence in respect of employment in
Government Sector/contractual persons deployed for e-governance project by way of documentary evidence and cross
examination of the same with available official records in their office.
d. For contractual employees, the HO has to get verified the credentials from the companies/vendors from where these contractual
employees have been hired/outsourced by way of getting a letter on letter head from the company/vendor.
e. Registration Authorities of NIC (NICRA) are not responsible for verification of credentials of the applicant.
f. For SSL server certificate the HO has to ensure the correctness of URL/IP address and must verify the physical location of web
server.
g. For System Certificate the HO has to ensure the correctness of MAC/Serial No./IP address of the system.
h. The HO has to put his signature and official seal for verification and the photograph pasted on the form.

C. Guidelines for NIC-Coordinator

On receipt of DSC application form, NIC-Co-ordinator must check & tick the Checklist based on information/documents available with
the DSC form before forwarding to NIC RA/CA Office. He/She has to put his signature along with official seal. In case of Class-3 DSC
applicant, Annexure-III has to be dully filled & submitted.
[Version: DSC Form V 6.2 (Doc-Id. Form-1) Updated on: 25 June 2014] Page 4
 ~oOo~

Ref. No.: …………………………………. (To be filled by NICCA/RA Office)

Annexure-III

Physical Appearance Verification Details

(To be filled by NIC Verifying Officer for Class-3 DSC applicant)

In-person verification of Shri/Smt/Ms…………………..………………............Class-3 DSC

applicant has been carried out on …………………… (dd/mm/yyyy) at .................(hh:mm).

He/she has shown his/her departmental-id/Service verification letter bearing No.

…………….……………………….

His/her signature & photograph have been matched with signature & photograph available
on his/her departmental-id card/ Service verification letter as well as DSC application form.

His/her signature & photograph have been attested by the undersigned as shown below.

His/her mobile No. is ………….………………..

Photocopy of departmental-id card attested by HO is attached herewith.

Paste passport Applicant’s Signature

size latest (To be signed in the presence of verifying officer)
Photograph of
Applicant (For
class-3 certificate …………………………………….………..
only)
Attested by NIC
Verifying Officer

Photograph to be Attested by NIC Verifying Officer (Signature & Stamp across the photograph)

Attested/verified by:-

Name/Designation/Emp. Code
Email:
Telephone/Mob No.:
NIC Centre/Location:

[For Class-3 certificate only - This Annexure is to be attached with DSC form & forwarded to the respective NICCA/RA Office Please ensure all
the fields are filled up]

[Version: DSC Form V 6.2 (Doc-Id. Form-1) Updated on: 25 June 2014] Page 5