Government of West BengalFood & Supplies Department

llA Mirza Ghalib Street, Kolkata-700 087

Memo No.91 SS- FS/SecttJFoodl14R-0112013 (Part-I) Dated 1st February,2016

ORDER

Subsequent to the rollout ofNFSA & RKSY on 27.01.2016, it has been decided that it will

be open to public to apply for getting ration under the Khadya Suraksha Yojana by making

applications in the designated forms as detailed below:

(i) Form III-R ( For Rural Areas) & III-U (For urban areas) for making applications to

include persons/family members who have been entirely excluded from the current list of

NFSAlRKSY(except auto excluded persons).

(ii) Form IV-R ( For Rural Areas) & IV-U (For urban areas) for applicants where some

members of a family find place in the NFSAlRKSY beneficiaries list but they desire to

include the left out family members.

(iii) Form V-R( For Rural Areas) & V-U (For urban areas) for rectification of errors, if any,

in the name/address ofholdr in the existing NFSA/RKSY cards.

(iv) Form VI-R ( For Rural Areas) & VI-U (For urban areas) for requesting change in the

tagging of ration dealers.

2. The submission of applications III the above-noted forms may commence under the

instructions of respective District Magistrates and the Municipal Authorities only after the

distribution ofRKSYINFSA cards are complete in each BlocklMunicipal Ward.

3. All applications shall be received only at the Block Food Inspector's Office in case of rural

areas, at Municipal Food Inspector's Office in non-SR Municipal areas, at RO's Office in case of

SR areas and in the Office of the Deputy Manager of Borough Offices in case of Kolkata Municipal

Corporation.

4. The guidelines and modalities of enquiry and preparation of database will be issued in due

course to the respective authorities.

~.~ ..Special Secretary

Enclo: Specimen of Forms as stated above

-,

Memo No.91-SS FS/SecttlFoodl14R-Ol/2013 (Part-I) Dated l" February,2016-02-01

Copy forwarded for information and necessary action to :

1. Commissioner, Kolkata Municipal Corporation, 5, S.N. Banerjee Road, Kolkate-700013

2. District Magistrate (All)

3. Director District Distribution Procurement and Supplies, West Bengal

4. Director of Rationing, West Bengal

5. Joint Secretary (Food Cell)

6. Private Secretary to Hon'ble Minister-in-Charge, Food and Supplies Department

7. District Controller of Food and Supplies (ALL)

~.~~Special Secretary

$5,~~••.••.•........•...........••...• ~ , GW11 ..........•••....•...................•.~,~ ~~~~~~~'lT~~~~~~~~ I ~~l!RJ~~1

'1rn<'lIG'li'l ~mN 0l(;~f&4'i'lC'fi'l" ~

~ Gf"Tif <m- ~ ~ ~cfEPIC .,~ ~ (~~ (1'fOff ~~AHL TIN" '1rn<'lICi'li'l ~ ifIlf ~ ifIlf ~

(~~(l$G( ~.~.~oll!o 8~ lIT!fl ~/(ll"8f.r

Adhar .,~~ 3lI]if) ~) ~~~

>r~~ ~ 4>Wi1)

ar'I'1 ~<m- if~, ~\3 if~

ar'I'1 ~!fir'f

ifI6f* \3 if~,( APL/BPL/AAY)'

;

-

.(lPlif ~ ifIl[ \3 if~ !Nlf ~ ~I 0liIT ~ ~ 4'lt if~, ~\3 if~, (lPlif ~ ifl'!* \3 ~, (lPlif ~ I:fll"<f

•• AHL TIN

~~~~

(~) <>m-~ ~ ~ ~ (AUTO EXCLUSION) ~f.r ~ ~ ~ ~ (~f.rll ~ ~-m ~f.r~) I (~) ~ ~ oml()) '6 (~) ~ 1R'U t"rtt ~ OR! ~ t'f'd; ~

~. f.r:-~ <!Tf\l;>$T~ liTIn ~~

"'.~8.~-~Q. ~~W~3f.r'l'>!o. C'!"f'11ffiJ mC'1-3'Wf -3m'fI"i 'fi' j<j>~ f.If'!t ~ 1ll:'f('i j1fif 'lfif'mr9.~ 'lfif'mr(lNf(i[ ~>!o (>({q> Q;' ~ 0I'J0fm ~ 5f'i5IT ~b'. ~ 'lfif'mr(lNf(i[ ~>!o (>({q> Q;' ~ 0I'J0f'rR 5f'i5IT ~ jq; ~!JlW[ j~ lI'Wrr;,. ~ 'lfif'mr>mf «Iil'f j~ 5f'i5IT ~ jq\ C"'f>ilR «Iil'f ~ m ~ 5f'i5IT ~~o. ~~~~'lfif'mr~s. ~Q ~ ~ 0I'J0f'f[i$:lf 5f'i5IT COltj1fif 'lfif'mr~~.~ 'lfif'mr~~ ~~" f3w.r;r~"'.~~iP.<.~~~

~: ~@~~ p~Fr- lliBfft'fa WIT':l. ~-~N-~If]"-~~:-~~~ ~~0ffif0%~~~.~N-~If]"-~~'fR-~~~'f~~F~, ~I~(~s{;~ 8~R,\!). ~o,ooo/- bl'f;TlH'Cf~ ~'f1ff-3:n~;)6fGf ,~~~8 ..~~~~ ;)<fiO)Gf>ftPIT~/~~~~Bm'lf-~en ~-~>f~~(~en~-(~~

~. ~~fu>fc<f>i~4ilm~ ~~~-SoR''1m;qlm~ ~ ;)<fiO)Gf'>i'1(5mpn~~':lo,ooo/- ~~

9. ~ en ~ 811fo'f ~ ;)6fGf<nfu>'b'. \!) en ~ c<Wr~ ~ ~ 01-3:n<'f -3 ~ ~ ;)6fGf~:". @;o)~;)6fGf~

':loo"fi'RS'-~(bPl(JiiIOi ~ ;)6fGf~

':l':l. ~.~ ;)~c<Wr(>ib~~ ;)Cf~~ ;)~~en~ ~Wf~ ~~ ;)6fGf~

':l~. ~ ;)<Pi'fen~~~(til-~enf~.:Pi)51f<'r(>ib~~~ ;)6fGf~

~,ontn ~................................. If'I' , 01'1T ......................•...............•

~,

~~~~~ ~~~~/~~~~~'S'fJ~~~1 ~fu~~/~~~I~/~~I!ll~Rlo~~~~I ..•

'1rnQICiHI ~ ~ ~ mlliJ 'I1'U

I '1rnQICl'HI ~~~~OWI1J..'l'I!'1~~~'I1'U

~ <wr '%'r ~~~ ~~~<:$ 1J..'l'I!'1~f.l!l'tJ

~/~ ~~~~/'Il1(fflI0WI~

~~'Ol11I'%'r/ ~ Offi:l! ~ m EPIC .,~ Offi:l! ~ ~ (AAY IPHH ~"'~<ffl;'f

\$~~ ~ 'ifI6f ~ ~~~/

~~ /SPHHI RKSY-DR<:$'I""'f'lI (~~ (~ m ~'f <roIOO

(,.,.~o~~) ~ ~- a~'l'O'fL1[~Adhar.,~ ~~ I/RKSY-II) ~~~~'l'O'fL1[ ~~~~'f~

~~~"R ~~'I""'f'lI) 'f'i'U~~~

<£l~/SECO~~~ 'Ol11I'" '6~ I!5RJRJ<ffl;'f

I1fflQ! ~~.

1 2 3 4 5 6 7 8 9

-- ---- r------

. I"tlS ~'f <roIOO ~ ~ ~ ~'f 'f'i'U~~~<.!l~<£l~~'f~~<Rl~~~~'6~ ~~

$5,Of(t;l"~

................................. ~,~ .~,

~~~~~~~

~~ (mOl AAYI SPHH I ~~~~~ ~~~~~~~~ ~~~~~~ PHH I RKSY-II

RKSY-II)

;

~ "It'lMil!

~~~~~~~ ~ \lR ~ ~ ~ <l1-~~ ••.

~~~~'"W!~-~~~~~"lm(;\l1il~

i'llmltt?l~

~ ~o'::,\b-'?l" ~ ~ ~,,:rrGr'fif q%

3fu".3fu"."IT'i\"~................................. ~.~ .

-- - --~C\SI\giI?l ~ ~~'f ~~ ~~~~ ~~~~ ~~~~OR (~ AAYI SPHH I PHH I ~~~ ~ ~~~~'8 Wi~~~ ~~~<t

RKSY-II RKSY-Ii) omf '6~

;

m~ fll~f.t~'\I'1~

~ ~ .,.~ «mm/ ~ ~ fll~f.t~'1IMftl /Off'il ~ fll~f.1~'1IMft/ ~ IC\WfT •••••.....••••••••••.•••••...••••...•..

~,

~~~~~~~~~'lT~~~~~~~ ~10!11f~~~~1

~/(~-

~-~~~"' •. ".,. 'J1R

~(1.l"'lif~~ EPIC .,~ '1rn<lICiHl ~ (~~ (INT

>nN~"P.l1'f ~~p

~~'1 AHl TIN-- '1rn4ICfll'l ~ ifl1f ~ ifl1f ~(~~C5m'

(;.;.~o>O af.rn- 1!{!;Il Ri5/ (ll'a~ ~Adhar .,~

~~)~) ~i5m~

>r~om ~~)~ .,~ <Wr-S .,~ @"Tif @"Tif ~

!~ ~'fifl1f* -s .,~ (APL/BPL/

AAY)-

-'-- - --

OCif'lif ~ on-r \3 if~ 3'"ilf l'fltr.f ~I ~ ~ (l$'Clf <PJt ~,-.;;f.r\3 if~, Cif'lif ~ ~ \3 ~, Cif'lif ~ lfl'f'f •• AHL TICl

~1!!!tlr6~t1I

(~) 9fll-~ ~ ~: ~ (AUTO EXCLUSION) ~~ ~ ~ ~ ~ (~~ ~ >rt'lQ'T ~~ ~) I(~) ~~ornl

I

I

IIiII

"

~~ flI'-Sf.1I1l<1I'1~~ ~ 'n c<mm/ ~ ~ flI'-Sf.1I1l<1IM~1 /Ofitii ~ flI'-Sf.1I1l<1IMft / ~ I

(O'i'1l .....•..•................•.............

~,

~~~~~ ~~~.~/~~~~~~~~I ~%~~/~~~I~/~~\!ilij""~?l~~~1

.'1m ql(j'l?l ~ ~~~ ~~'lI~~ ~~"lmU-.oo

I '1rnql(lHj ~/~ ~~~13Rf ~~'lI~-.oo~~/~~~ ~~t"'<MJ

<mf/~~~~ ifI1f ~ ~~ ~~<f DFlI3Rf ~ (~ ~~"l11T

EPIC .,~ ~ ~ ~ ~ ~- (/:'R~~ ~0lT~~'f(

DR~~~ ffi"rn" ifI6f ~ <i?fl1~ ~ / (AAYIPHHlSPHHI ~~~'R~ ~fiit1!~'f~

Adhar.,~('.'.~O}\b~)

~<mf ifl!. RKSY -URKSY -II) ~~~) ~'lI'!lRJ~~~

~ ~ 'lli'lJ~~~o.!l~SECC~

~~ "l11T0lT _ I!5RJRJ'ffl!'f~~~.1 2 3 4 5 6 7 8 9

----- -- -.-

.. fiit1! ~'f ~ ~ 'lI '!lRJ 'fflI"C'f~ 'lli'lJ ~ ~ <m! o.!l~ o.!l~'fflI"C'f ~ ~'fl! *'lI ~ ~ -e ~ ~

I

m~ f1t\sf.l~j<1''1~~ ~ 'if~ c<mm/ ~ ~ : f1t\Sf.l~<lIMre' /OWIT ~ f1t\Sf.l~'1'Mre / ~ "

~ .om"P.l',~ ~ ~.~ ~ ~ ~ ~ ~I ~ ~ ~ ~~, ~ ~ ~ ~ <IT. ~~ 9jR<t\6c"'l~~ ~ ~I

~/(~-

~-~~-~- ~~"i ~~-~~~.~ ~~~~<rr~ ~~~<rr~~ (AAYIPHHlSPHHI ~~~

RKSY-IIRKSY-II)

;

,

~I m <IT• ~~ ~~ ~ ~ ~ "R.~ (~faf)~ ~-~~'!1"'fil!~<I#~~f$<I#~ ~ <.!R ~ ~ ~ <.!l-~ <1#f.iRR ~<I#

~9fP!~-<!:Rl~~~~"IW1C">1il~

m-~ fiI\r;f.t~<lI"1 'lit~

~ ~ ,,~ c<mml ~ ~ fiI\r;f.tf?1<lIM~1 lontii ~ ~~ I ~ I

(Ol"IT •.•.•••••.•••••••.•.•••.•••.•...•••.•..

~,

~ ~ ~ ~ ~ ~ ~ ~ ~/ ~ ~ ~ ~ ~I ~ ~ ~ ~ 9jffi<ll6c~~iSM)' ~ ~I

~/(~-

~-

~~'i ~~~~C~I'&I~ ~ (AAY/PHH ~~ ~~~~ ~m~ ~ ~ <!l1O'f ~~~~ /SPHHI ~~~ ~ ~~~~'e

~~'e <ffi'iRKSY-I/ ~RKSY-II) ~

.. - . -- _. __ .

I