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IGCA_User_Form_V1.1

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Suraj Bhujbal
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10 views

IGCA_User_Form_V1.1

Uploaded by

Suraj Bhujbal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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New User Application Form

ATTENTION: Dr. Subrata Chattopadhyay

Personal Information

Title: Mr. Miss. Mrs. Other_________________ Gender: Male Female

Full Name: ____ ________________________________________________________________________________________

Photo ID card no: ____ _____ Position: ___________________________


Organization: ___ ______________________________________
Address: _ _

Telephone: _____ ___ Mobile: ____ ____ Fax: ______ _______

Email: _______ _______________________

SERIAL No.______________________________________ (‘Serial no.’ from Online Registration Form)

Subscriber Signature: ________________________________ Date: __ __/____/_____ (DD/MM/YYYY)

Registration Authority Section (To be filled by RA)

Approve Reject

Identification Document: Photo ID card

Comment: ______________________________________________

RA Name: _______________________________________________

RA Organization: __________________________________________

RA Signature: ________________________ Date: ____/____/____ (DD/MM/YYYY)

CAO Section: Result Certificate

Issue Complete
Reject
**Note: Photo ID card - ((Passport, PAN card, Work ID or Driver’s License)
CAO signature: ______________

Date: ____/____/____ (DD/MM/YYYY)

________________________________________________________________________________________
Contact Information

IGCA Garuda Grid Operation Centers Certificate Authority,


#1, CDAC Knowledge Park,
Old Madras Road, Byappanahally, Bangalore – 560 038, INDIA.
Tel. +91-80-25246353, 080-66116511 Fax. +91-80-2524 7724
Contact IGCA Manager : [email protected]

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