CPDW (Compassionate payment on account of Human Kills, Human injury, Cattle Kills, Crop damage or House damage by Wild Animals)

Applicant Information

Applicant Name

Applicant Mobile No.

Applicant Email

Applicant Age

Father/Spouse Name

Bank Name

Branch Name

Bank IFSC Code

Bank Account No.

ID Proof Type

ID Proof

Bank Passbook

Damage Information

Animal

Damage Date

Circle

Division

Range

Section

Beat

District

Block

Gram Panchayat

Village

Crop Damage

Paddy Crop

Cereal Crop

Vegetables Crop

Cash Crop(Banana,Sugarcane,Mango etc..)

Damage Area(In Acre)

Photograph

NOC(Land Owner) Copy

R.O.R./Sale Deed Copy 1

R.O.R./Sale Deed Copy 2

R.O.R./Sale Deed Copy 3

R.O.R./Sale Deed Copy 4

House Damage

Fully Damge

Partially Damge

Photograph 1

Photograph 2

Photograph 3

Photograph 4

R.O.R./Sale Deed Copy

R.I. Report

Cattle Kill

Name of Animals

Number of Adult/Calf

Photograph

VAS/BVO

Human Death

Photograph

Letter from Sarapanch

Police FIR Copy

Police Enquiry Report

Death Certificate

Legal heir Certificate

Postmortem Report

Human Injury

Human Injury Permanent

Human Injury Temporary

Photograph

Medical Certificate

I here by declare that the content of the application is correct.*