ServicePlus- ePass

GOVERNMENT OF TAMILNADU

APPLICATION FORM FOR VEHICLE e-PASS FOR ESSENTIAL SERVICES

Applicant Details

Whether you are from the containment zone? *

Yes

No

Full Name of the Applicant *

Mobile Number *

Date of Birth *

E-Mail

Type of Applicant *

Last 4 digits of Aadhaar Number

Address of the Applicant

House No/Bylane No/Street Name *

Landmark/Locality/Ward No *

District *

Tehsil *

Police Station *

Post Office *

Pin Code *

Pass Details

Vehicle Registration No *

Vehicle Type *

Journey Type *

Purpose of Travel *

Pass From Date *

Pass To Date *

From (Source of Route) *

To (Destination of Route) *

Remarks (Reason justifying travel) *

Members Travelling

Name *

Age *

Mobile Number *

Name *

Age *

Mobile Number *

Declaration

All the information provided in the form is correct to the best of my knowledge. If any information furnished here is found incorrect or falsely represented, I understand that legal action will be initiated against me.

I understand that the authorities decide on pass availability and validity and may accept or reject my application without giving any reason thereof. I accept that pass if issued is liable for cancellation as authority may please.

The persons travelling must confine themselves to home quarantine for 14 days on return to the district.

I Agree *

Additional Details

Applied to the Office*

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