Collectorate North Goa : Online Application For Obtaining Income Certificate For Mediclaim
Organization : Revenue Department, Goa
Facility : Obtaining Income Certificate for Mediclaim
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Home Page : http://www.collectornorth.goa.gov.in/home.aspx
Apply here : http://www.collectornorth.goa.gov.in/appln/UIL/IncomeCert_af.aspx?__Key=&_Mode=
Download Affidavit :https://www.statusin.in/uploads/1300-Income%20affidavit%20format.pdf
Obtaining Income Certificate for Mediclaim :
** This Application Is Addressed To Mamlatdar of the concerned Taluka
** The Fields marked with * are compulsory.
Related : Online Application For Obtaining Domicile Certificate North Goa : www.statusin.in/1311.html
** Incase relevant documents are not uploaded,the application will be subjected to cancellation.
** The Reference No. generated after submitting the application online should be maintained for tracking the status of the application.
Application for Obtaining Income Certificate for Mediclaim
** Applicant’s Name* :
** Mobile No :
** Email Id : & Id Proof:
** Enter the id Proof Number* :
** Personal Details of Applicant
A)Name B) Occupation* :
C) Name should be as per Birth Certificate
D)Spouse’s Name E) Spouse’s Profession :
F) Place of Birth & Date of Birth
G ) Age* in years House No*Ward/Road/Locality* :
H) Taluka* :
Mention each of their Income :
** Total Family Income* :
** Any Other Income :
Detail of the relationship :
** profession,
** age,
** income of the family members (including head of the applicant)
Note :
If it is found that the applicant questions set above are incorrect by benefit derived hereby be summarily cancelled.
Following documents should be uploaded
(1)Salary Certificate,if any.
(2)Attested Copy of Ration card.
(3)File an affidavit containing therein full details such as name of the patient (or in case of minor name of parents)and the voters list enrollment number. (4)Attested Copy of Birth Certificate,EPIC card,Doctor’s Certificate from Goa Medical College,Income Certificate from local body and 15 years residence proof.