Application Form for Reservation of Ship Tickets
APPLICATION NUMBER:
ANDAMAN & NICOBAR ADMINISTRATION
SHIPPING CORPORATION OF INDIA
REQUISITION FOR ACCOMMODATION FOR TRAVEL BY SHIP FROM RAJ NIWAS/
ADMINISTRATION QUOTA/ GOVT. EMPLOYEES QUOTA
| Name of Vessel | : | |||||||||||
| Tentative date of sailing | : | |||||||||||
| Sailing from …………………………………….. to …………………………………………… | ||||||||||||
| No. of Berth(s)/ Seats ………………………………………… | ||||||||||||
| S.No | Name of Applicant | Relation | Sex | Age | ID No. | Class | ||||||
| 1. | ||||||||||||
| 2. | ||||||||||||
| 3. | ||||||||||||
| 4. | ||||||||||||
| 5. | ||||||||||||
| 6. | ||||||||||||
| 7. | ||||||||||||
| Purpose of journey | : | For Visitors of A&N | ||||||||||
| Islands: | ||||||||||||
| Permanent Address | : | Duration of stay in the | ||||||||||
| Islands: | ||||||||||||
| Address in A&N Islands | ||||||||||||
| Permanent Address | ||||||||||||
| Phone No. | ||||||||||||
| Strike whichever is not applicable. | Applicant Name: | |||||||||||
| Signature with date: | ||||||||||||
FOR OFFICE USE ONLY
The applicant is drawing basic pay of Rs. ……………. and working as ……………………………………
……………………………………. has been granted …………………. days leave with effect from
……………… to ……………… to enable him/ her to visit home town/ mainland. He/She will be accompanied by the following family members.
HOD/ Office
_____________________________________TEAR HERE _______________________________________
Receipt No. …………………… Application No. ………………. received an application for accommodation for travel by MV ………………………………….. tentative sailing on ………………..
from ……………………… to ……………………….
Initial of Receipt Clerk
With office seal
