Service Details

Service / Corps *

Service Number *

Rank *

Group (JCOs/ORs)

Record Office

PPO Number

Personal Details

Applicant Name *

Relationship & Name *

Date of Birth *

Age (auto)

Date of Enrolment

Date of Commission (Officers)

Date of Retirement *

Qualifying Service (auto — Enrolment to Retirement)

Disability % (if any)

Date of Death (if deceased) Father / Husband / Son — as applicable

Address & Contact Details

Postal Address *

State *

PIN Code *

Mobile Number *

Alternate Phone / Landline

Email Address (stored in small letters — used for receipt) Membership receipt will be emailed to this address

Next of Kin (NOK) Details

NOK Full Name *

NOK 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

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

Fee Structure — Life Time Membership: Officers — ₹ 100 | JCOs — ₹ 50 | NCOs — ₹ 30 | ORs — ₹ 20 | Single Ladies — Nil
Donations exempt under Sec. 80G, Income Tax Act 1961

Donation (Optional — can be added later)

Donation Amount (₹)

Donor PAN (for 80G)

Donation Date

Purpose (optional)

Payment Details

Payment Mode *

Chq / Transaction / UTR / UPI Ref. No.

Payment Date *

Bank Name

Cheque No. 1

Cheque No. 2

Total Amount (₹) (auto)

Joint Photograph

Pensioner with NOK

Upload Joint Photo (JPG/PNG/PDF, max 2 MB)

Joint photo of Pensioner with NOK | Paste & self-attest on physical form | Write Membership No. on reverse

Declaration

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

TRI SERVICES EX-SERVICEMEN WELFARE ASSOCIATION (TSEWA)

Regd. No. 495/2015 | ISO 9001:2015

Flat No.101, H.No. 1-1-78/5, Edifice Pride, Valluvar Nagar, Ammuguda, Behind CDM, Secunderabad – 500 094
Mobile: 9494037781 | LL: 040-40176569 | Email: triservices.hyd@gmail.com | Web: www.tsewa.org

Membership No.

________________

Joint Photo
(Pensioner with NOK)

(Paste Photo &
Self-attested)

MEMBERSHIP FORM: VETERANS / SINGLE LADIES

1. Service / Corps: Army / IN / IAF

Service No.

Rank

Group (JCOs/ORs)

2. Applicant Name

S/O, W/O, D/O, F/O

3. Date of Birth

Date of Enrolment

Date of Commission

4. Date of Retirement

Qualifying Service

Disability % (if any)

5. Record Office

PPO No.

6. Postal Address

State

7. Contact No.

Alternate No.

Email-id

8. NOK: Name

Relationship

DOB

10. Membership Fee Rs.

Officers- Rs.100/-, JCO's- Rs.50/-, NCO's- Rs.30/-, OR's- Rs.20/-, Single Ladies- Nil (Life Time)

DONATION

11. Voluntary Donation Rs.

Donor PAN No. (for 80G Receipt & Form 10BE)

(Donations to TSEWA are exempt under Section 80G of the Income Tax Act, 1961.)

PAYMENT DETAILS

12. Cash / Chq / Online Tr ID. No.

Date

Bank

I abide by the bye-laws of TSEWA and shall not undertake any activity undermining reputation of the Association.

Place: Secunderabad Date:

Signature of Applicant

✂ TEAR HERE — OFFICE COPY ✂

TRI SERVICES EX-SERVICEMEN WELFARE ASSOCIATION (TSEWA)

Regd. No. 495/2015, ISO 9001:2015 | Membership Receipt

Hearty Welcome to TSEWA, Rank: Name:

TSEWA Membership No.: We have received Rs. as Membership Fee

and thank you for your generous donation of Rs. as Donation/Corpus, which we gratefully acknowledge.

(Donations to TSEWA are exempt under Section 80G of the Income Tax Act, 1961.)

Place: Secunderabad Date:

(Authorised Signature)

Remittance of Money to TSEWA Bank Account:
All cheques should be issued in favour of "TSEWA". Bank: State Bank of India (SBI). A/c No.: 35088276014. IFS Code: SBIN0015568. Branch: Bhaskar Rao Nagar. UPI ID: TRISERVICESHYD@SBI.

SCAN & PAY
(QR Code)

Membership No.