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Supplementary KYC Document undertaking for Expanded PMUY

(To be submitted along with PMUY KYC Document )( PS:To be published in vernacular languages)    Name of tha Applicant         

aadhaar no of applicant    

Select category in which applicant is applying for tha gas cannection under PMUY.    
code   category of applicant applied   category document No (photo coppy to be submitted)        

01    Sc/St households    
02    PAMY(gramin)
03    Most backward class
04    Antyoudaya Anny Yojana(AAY)
05    Tea and Ex Tea garden Tribe
06   Forest Dwellers
07    Islands  River Island   
08    Poor HH as per 14 point declaration                             
       Undertaking for Availing LPG connection under Expanded pradhan Mantri Ujjwala Yojana         Dear LPGDistridutor

I,    ............................................... daughter/wifeof  ...............   Age   ...................   years,         resident                                                                                     

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