I am already enrolled with Schemes SASPFUW/BOCWA/WBTWSSS

Beneficiary Details

Beneficiary Details

     Aadhar Card limit is upto 2MB, JPEG/PNG/PDF
If you do not have Aadhar card tick here
  ID Proof limit is upto 2MB, JPEG/PNG/PDF

Bank Details
(If IFSC code is not mentioned,then please give reason for that)
     Passbook limit is upto 2MB, JPEG/PNG/PDF
Permanent Address

Present Address

Dependent Details
S.No Whether Registered under SASPFUW/BOCW/WBTWSS. If yes, then provide Registration No. Dependent Name Relationship Gender DOB Age (Years) Aadhaar No, if any Scheme PassBook

Nominee Details
S.No Name Relationship with applicant Gender DOB Age (Years) Share Allocation Bank Name Bank Account No. Branch Name IFSC Code

Form 1

Upload Documents
Photo of the Applicant *   Photo limit is upto 2MB, JPEG/PNG

Signature of the Applicant *   Signature limit is upto 2MB, JPEG/PNG/PDF

Any Other Document   Document limit is upto 2MB, JPEG/PNG/PDF

Additional Affirmation

PF/ESI Details

Employee Type

Income Details

I agree to abide by the Samajik Suraksha Yojana (Rules and Regulations) 2017