ServicePlus- Issuance of COVID-19 ePass for Movement

Union Territory of Ladakh

Application for Issuing of COVID-19 Movement ePass

ePass Requisition Type

District where you are presently at *

Which Type of ePass you are Applying? *

Intra District (Within the District Boundary)

Inter District (Outside the District but within State Boundary)

Inter State (Outside the State)

Applicant Details

Applicant Name *

Parentage (Father / Husband Name) *

Gender *

Male

Female

Transgender

Mobile Number *

Working E-Mail Address *

Applicant Photograph *

ID Proof Type *

Id Proof Number *

Address Details

Is the Area where you are residing declared as Containment Zone / Prohibited Zone *

Yes

No

Present Address *

Permanent Address *

Contact Address where Travelling *

State (Where Traveling) *

District (Where going) *

Provide Vehicle Information

Vehicle Type *

Vehicle Registration Number *

Request From Date *

Request upto Date *

Travel Route From (Source) *

Travel Route To (Destination) *

Purpose *

Additional Persons Accompanying with Pass Holder *

Pass to be issued in the name of *

Remarks

Person Information

Name *

Gender *

Mobile Number *

Name *

Gender *

Mobile Number *

Name *

Gender *

Mobile Number *

Name *

Gender *

Mobile Number *

Name *

Gender *

Mobile Number *

Name *

Gender *

Mobile Number *

Self Declaration

I declare that the statements made here is true to the best of my knowledge and belief and if anything is found untrue I shall be liable for a penalty as per law.

I Agree *

Additional Details

Applied to the Office*

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Word verification

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