Shri Amarnathji Yatra 2023
YATRA PERMIT Applicant’s
photograph
APPLICATION FORM
which
(Please fill in block letters) should be
signed
across this
Full Name: ________________________________________________________ photograph
FULLNAME:
Name of Spouse / Father: ____________________________________________
GENDER (Tick as applicable): Male Female; ; Blood Group:
Gender (Tick as Applicable) Male Female Blood Group: _____________
Age*: Yrs. (No one below the age of 13 years,
Age/Dob: _____________________ (Anyorone
above the age of 70 years will be registered for the Yatra).
below the age of 13 years, and above 70 years
NAME OF SPOUSE/
and women 6 weeks pregnancy will not be registered for the Yatra 2023)
FATHER:
with more than
Address: __________________________________________________________
ADDRESS:
State: ________________________________________
STATE: _ PIN
Pin: ________________
Aadhaar: ___________________________ Email (if any): ________________
E-Mail (if any):
CONTACT / PHONE NO MOBILE +91
Telephone with STD Code / Mobile number of the person to be contacted in case of any emergency _
To
The Chief Executive Officer,
Shri Amarnathji Shrine Board,
Jammu / Srinagar.
Sir,
1. I may please be issued a Permit for embarking on Shri Amarnathji Yatra. I shall
start the Yatra from the [Baltal / Chandanwari**] route
on _/ _ 2023.
2. I certify that I have been declared physically fit by the Authorized Doctor / Medical
Institute to undertake the journey to the Shri Amarnathji Holy Cave during July -
August 2023. The prescribed Medical Certificate is attached.
3. I , son / daughter / wife of , nominate
Shri / Smt. _ ; age ________; relationship:
_ to be paid the Insurance proceeds*** upon payment of the Insurance
claim in case of my death due to accident.
4. I solemnly undertake to abide by the Dos & Don’ts / other directions issued by the
Shrine Board / District Administration.
Full Signature of Applicant
* No one below the age of 13 years, or above the age of 70 years, and no lady with more than six weeks
pregnancy will be registered for the Yatra.
Please fill whichever is applicable.
*** A duly registered Yatri with a valid Yatra Permit issued by the Shri Amarnathji Shrine Board, duly endorsed by the issuing
Institution, will be entitled to an insurance cover of Five Lakh Rupees from the Insurance Company in the event of her/ his
death due to any accident inside the State of J&K while undertaking the Shri Amarnathji Yatra. The sum assured will be paid
through the Shrine Board after the nominee of the deceased Yatri completes the due formalities.
For Office Use Business Unit _ Branch
Bank Yatra Registration Slip No. Date _ Route issued
Seal and Signature of Initials of Official
Registration Officer