1 NAME OF COMPANY eg IOCL HPCL BPCL 2 NAME OF DISTRIBUTOR 3 Attach a copy of xFB01 rst page of DGCC booklet or recent cash memo 4 N AME OF THE LPG CONSUMER 5 YOUR REGISTERED MOBI ID: 115952
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*In case you have an e-Aadhaar, please fold it vertically and keep the left side (the side with your photo and Aadhaar Number as shown • Aadhaar (UID) letter • Lease Agreement • Telephone or Electricity Bill or any other Utility Bill • Self-declaration attested by Gazetted Offi cer • 1. NAME OF COMPANY (e.g. IOCL / HPCL / BPCL) 2. NAME OF DISTRIBUTOR 3. (Attach a copy of fi rst page of DGCC booklet or recent cash memo) 4. N AME OF THE LPG CONSUMER 5. YOUR REGISTERED MOBILE NUMBER or WHERE WE CAN CONTACT YOU 6. ADDRESS (F address is different from address in the Aadhaar Card, also attach a current proof of address**) Signature with date of LPG Customer as in Subscription Voucher (SV) 1. First page of DGCC booklet or copy of recent cash memo. 2. Photocopy of proof of address if your address with LPG distributor differs from address in Aadhaar Letter. Form-2 (LPG Linking Form) Step 1. Place your Original Aadhaar Letter* here as shown below: Step 2. Take photocopy of this sheet & fi ll-up the following details in the photocopy in BOLD BLACK / BLUE ink: ACKNOWLEDGEMENT SLIP:Received ‘Aadhaar LPG Linking Form’ from (Name) __________________________ / Consumer No __________ alongwith copy of Aadhaar.