TSEWA – Membership Registration Form

Service Details

Service / Corps *

Service Number *

Rank *

Group (JCOs / ORs only)

Record Office

PPO Number CORR / DIS PPO if applicable

Personal Details

Applicant Full Name * (in CAPITAL LETTERS)

S/o / W/o *

Date of Birth * As per service records

Age (auto-calculated)

Date of Enrolment Date joined service

Date of Commission (Officers) Officers only

Date of Retirement * Date released from service

Qualifying Service (auto-calculated from Enrolment → Retirement) Enrolment to Retirement duration

Disability % (if any) Enter 0 if not applicable

Life Status *

Address & Contact Details

Postal Address *

State *

PIN Code *

Mobile Number *

Alternate Phone / Landline

Email Address (CAPITAL LETTERS — receipt will be sent here) 📧 Membership receipt will be emailed to this address upon submission

Next of Kin (NOK) Details

NOK Full Name *

Relationship *

NOK Date of Birth

Is the applicant a Single Lady (War Widow / NOK)?

No Yes — Single Lady / War Widow

🎖 Single Lady / War Widow Details

Single Lady Date of Birth

Date of Death of Husband

Husband's Service Number

Membership Fee

Life Time — One Time Payment

Membership Fee Paid (₹) * Enter 0 for Single Ladies (Nil fee)

Fee Structure — Life Time Membership (One Time): Officers — ₹ 100 | JCOs — ₹ 50 | NCOs — ₹ 30 | ORs — ₹ 20 | Single Ladies — Nil (₹ 0)
Donations to TSEWA are exempt under Section 80G of the Income Tax Act, 1961.

Donation (Optional — can be added / updated in database later)

Donation Amount (₹) Exempt under Sec. 80G, IT Act 1961

Donor PAN Number (for 80G) Required for 80G Receipt & Form 10BE

Donation Date

Donation Purpose (optional)

Payment Details

Payment Mode *

Cheque / Transaction / UTR / UPI Reference No.

Payment Date *

Bank Name

Cheque No. 1 (if applicable)

Cheque No. 2 (if applicable)

Total Amount Paid (₹) (auto) Auto: Membership Fee + Donation

Joint Photograph

Pensioner with NOK — Paste & Self-attest on physical form

📷

Click to Upload Joint Photo

Pensioner with NOK | JPG / PNG / PDF | Max 2 MB

📋 Photo Instructions: ✔ Joint photograph of Pensioner along with NOK
✔ Recent, clear, passport-size photo
✔ Self-attest the photo on the physical copy
✔ Write Membership Number on the reverse side
✔ Paste photo and write Mem. No. on receipt stub

Declaration by Applicant

I hereby declare that the information furnished above is true and correct to the best of my knowledge and belief. I abide by the bye-laws of TSEWA and shall not undertake any activity undermining the reputation of the Association. I understand that my Membership Number will be issued upon verification and realisation of payment. I consent to receiving my Membership Receipt and communications at the email address provided above.

I have read and agree to the above declaration and the bye-laws of TSEWA. (Place: Secunderabad | Date: )