Sant Rohidas Leather Industries and Charmakar Development Corporation Ltd- Support for Marginalized individuals for livelihoods and enterprise  (SMILE)
Only for families whose bread earners (deceased person) have lost their lives due to COVID-19
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Name of Deceased Person  (Surname First Name Middle Name) *
Aadhaar number of Deceased Person( 12 digit Aadhaar number as mentioned in Aadhaar Card) *
Address of Deceased Person *
District of Deceased Person *
Taluka of Deceased Person *
Gender of Deceased Person *
Age of Deceased Person (At time of death) (Should be between 18 to 60 years) *
Date of birth of the Deceased Person *
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Caste of Deceased Person *
Sub caste of Deceased Person *
Whether annual income of the family of Deceased Person is upto Rs 3,00,000/- (three lakh rupees) *
Total count of Immediate family members of the Deceased Person *
Reason for death of the Deceased Person *
Date of demise of the Deceased Person *
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DD
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Name of Immediate relative (successor) of the Deceased Person *
Contact number of Immediate relative (successor) of the Deceased Person (1o digit valid Mobile number). *
Relation of the Immediate relative(successor) with the Deceased Person *
Required
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