Application Form For E Mitra Kiosk – Fill Out and Use This PDF

Application Form For E Mitra Kiosk PDF Details

The Application Form for E Mitra Kiosk enables individuals and companies to register as Local Service Providers (LSPs) and operate e-Mitra service centers across Rajasthan. This form is administered by the Department of Information Technology (DoIT) and is required for all new kiosk applications as well as ownership transfers of existing kiosks on the eMitra portal.

Who Needs This Form?

You need to complete this application form if you intend to:

• Open a new e-Mitra service center in any district of Rajasthan
• Register as a Local Service Provider (LSP) under the eMitra program
• Transfer or update ownership of an existing kiosk on the eMitra portal
• Apply for a kiosk that operates at multiple service levels

Eligibility Requirements

Before submitting the application form, applicants must meet the following criteria:

• Residence or business operation within Rajasthan
• Minimum educational qualification as specified by the district authority
• Valid photo identity proof (Aadhaar card, voter ID, or passport)
• Bank account details for processing financial transactions
• Police verification certificate from the concerned police station

Required Documents

Gather the following documents before filling out the application form:

• Photo identity proof of the kiosk owner
• Proof of permanent address and kiosk center address
• Educational qualification certificates
• Police verification certificate
• Bank account details and passbook copy
• Passport-size photograph of the kiosk owner

How to Complete the Application Form

Complete each section of the application form accurately to avoid delays in processing:

1. Basic details: Enter your district name, current LSP information, and attach a recent photograph of the kiosk owner.
2. Ownership type: Specify whether the kiosk is owned by an individual or a company and provide the owner's full name, permanent address, contact number, and email ID.
3. Kiosk center information: Enter the kiosk center name in both English and Hindi. Provide the full address, contact details, and the name of the concerned police station.
4. Urban or rural setting: Indicate whether the kiosk is in an urban or rural area and provide the corresponding address details.
5. Bank account information: Provide the bank account details of the kiosk for processing financial transactions through the eMitra system.
6. Existing kiosk details: If the kiosk is already registered on the eMitra portal, enter the kiosk ID and the associated LSP name.
7. Document checklist: Confirm that all required documents are enclosed, including ID proof, police verification, educational certificates, and bank details.
8. Declaration: Sign the declaration confirming that all information provided is accurate and complete.

For other government and official documentation, see our business registration form and notarized identity verification form. If you need to open a bank account for kiosk operations, the bank account activation form provides relevant documentation details.