CIVIL SUPPLIES AND CONSUMER PROTECTION DEPARTMENT

Application Requesting Renewal Of Family Card For Which Stop Supply Of Essential Commodities Ordered

From Name                                        : Old Address  as in ration card  :          Old door No.                            : New door No.                           : Street Name                              : Place Name                               : Zone Name                               :

Actual Address currently holding in Old door No: New door No: Street Name: Place Name :                              Zone Name  : Telephone    : Cell Phone   : E-mail          :

To

Assistant Commissioner,

Civil Supplies and Consumer Protection Department,

…………………………Zone,

Chennai 600

Sir,

                        Sub:     Stop Supply of essential commodities ordered for my family card

                                     Request for resumption of supply – regarding

When I went to fair price shop to draw commodities / viewed through website, I came to know that you have issued orders for stop supply of essential commodities to my family card ‘A’ Register No………………….Family card No…………Shop code……………………

When inspecting officials from your department came for verification to my area,* I was out of station / went to hospital / went to office / have changed my address. Hence I could not show my family card for verification.

Now *I am residing in the above address mentioned in the family card / have changed my residence from the address mentioned in the family card to the new address given above.

I have enclosed *Xerox copy of my family card and copy of residential proof viz. Electricity connection card / telephone bill/voter identity card /Passport /Slum clearance   board allotment order / house tax receipt / LPG refill cylinder bill / Identity card issued by postal department. Verify my residence in the address given and issue orders for resumption of supply to my family card early.

I also declare that   except the family card. I possess in the address given, I do not possess any family card in any other address, Names of the members found in the family card have not been included in any other family card, Later if the above information is found to be false, I know that criminal action will be taken against me.

Enclosed

1.Ration card Xerox

2.Proof of residence document

Date:                                                                                                                                                                                                                                                                                         Yours faithfully,

Place:

Acknowledgement Slip

1.Fair Price Shop	Code:                            Name:
2.Serail No
3.’A’ Number / Family Card Number	A No:                            Card No:
4.Card Holder Name

                              Your appeal petition has been received. Until your appeal petition is disposed, you can draw essential commodities in this fair price shop in which you are earlier drawing essential commodities. You may also know the details of disposal your application in this fair price shop within a period of 90 days.