CERTIFYING AUTHORITY

Recognized by the Controller of Certifying Authorities

TATA CONSULTANCY SERVICES LIMITED CERTIFYING AUTHORITY REQUEST FORM FOR CLASS 3 CERTIFICATE INSTRUCTIONS

USER TYPE INDIVIDUAL

Gender* Male Female

Validity of DSC*

c 1Year d e f g
Surname^ Father/Husband's Name e-mail Address

c 2Years d e f g

*^

Given Name*^ Initials^

Alternative e-mail Address

Organisation details

Name House Identifier Street Address City Country Telephone

Residential address

Pin Code State

Mobile

House Identifier*^ Street Address*^ City*^ Country*^ Telephone*

Pin Code*^ State*^ Mobile

DOCUMENT CHECKLIST FOR INDIVIDUAL TYPE OF CERTIFICATE Subscriber proof of identity and residence(Any Copy ATTESTED by GAZZETTED Officer / Bank Officer)

c d e f g c d e f g

IdentityandResidence

c Passport d e f g
Identity

c d e f g c d e f g c d e f g

DrivingLicense

c PANCard d e f g c DrivingLicense d e f g c PhotoIdentityCard d e f g c d e f g

Residence

Passport BankA/CPassbookwith Photo

c LatestTelephoneBill d e f g c LatestBankStatement d e f g c DrivingLicense d e f g c LetterofAuthority* d e f g

Applicant Declaration

c d e f g c d e f g

LatestElectricityBill Passport

RA Declaration

IherebyconfirmthatIhavereadandunderstoodtheaboveinstructionsandwill followtheaboveinstructionsforobtainingandusingtheDigitalSignature Certificate.

Date:Place:-

IherebyconfirmthatIhavereceivedandverifiedthedocumentssubmittedby thesubscriber.

Date:SignatureoftheApplicant Place:SignatureoftheApplicant

RA OFFICE NAME : TCS-CA - Registration Authority / USER ID : __________________ / REQUEST NUMBER :____________

The certificate Request Form, Online Enrollment Form, Demand Draft and the supporting documents as per the document checklist have to be forwarded to the following address:
Duly mark the envelope as 'APPLICATION FOR DIGITAL CERTIFICATE' TCS-CA - Registration Authority

Tata Consultancy Services [Certifying Authority - PKI Services] Advanced Technology Centre deccanpark 1 - Software Units Layout Madhapur Hyderabad -500 081

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