Government of India Ministry of Electronics & Information Technology
NATIONAL INFORMATICS CENTRE
Single User Subscription Form
Registration number : SINGLEUSER-FORM202504030010
Personal Details : Reporting/Nodal Officers Details :
Email Officer Name : Chibor Shullai
[email protected]Address.: Officer Mobile : +919402196012
Mobile: +919711768527 Officer Telephone : 0121-265610
Designation: ACWE B/R Officer Desigantion: CWE
Emp Code: 317243
Organization Details :
HQ Commander Works Engineers No - 2
Address:
Meerut Cantt
State: UTTAR PRADESH Category : Central
City: Meerut Ministry: Ministry of Defence
Pincode: 250001 Department: Military Engineering Service
Single User Subscription Details:
Type of Request : For Self
Type of Mail ID: mail
Email address preference : id_name
First Name : Shawez
Last Name : Khan
Date Of Birth : 05-06-1986
Date Of Retirement : 30-06-2046
Employee Description: emp_regular
[email protected]Preferred Email Address 1 :
Signature of the Applicant with date & seal Signature of Reporting/Nodal/Forwarding Officer with
date and seal
Signature of NIC COORDINATOR with date and seal
For office Use
Billing Division(RR Section):
Payment Processed: Yes/ No:
User ID Creation:
Assigned login ID: ----------------------------------------- Domain ---------------------------------------
Remarks(BO/PO): ---------------------------------------
Signature of iNOC incharge
Signature of the Operator
Name & Designation:
Terms and Conditions
01. Users are requested to keep the given userid and password a secret.
02. Please change your password at least once in every three months.
03. By not doing so (point no. 1 & 2 above) the account may be compromised by hackers and the hacker can use the
same account for sending spurious mails on the accounts behalf. NIC is neither responsible nor accountable for this
type of misuse of the compromised mail accounts. Gross misuse might be detected by automated monitoring tools,
which in turn will automatically deactivate the account
04.
04. Do not use the Save password option on the browser when you are prompted for it .
05. Users are requested to keep the given userid and password a secret.
06. Users are requested to keep the given userid and password a secret.
Application Approval Details for Reg No - SINGLEUSER-FORM202504030010
Submitted
Submitted By : IP Details : Datetime : Status :
To :
User (User ([email protected], 2025-04- mrtpbz3- Pending with RO
106.223.176.27
+919711768527)) 03T10:16:31
[email protected] /Nodal/FO
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