N. K.

Poddar e-Comm IT
P-3 New CIT Road (Tiretti), 2nd Floor, Kolkata 700 073
Email : nkpecit@gmail.com Web : http://www.ecommit.in

Ph Cell Fax

: : : :

(033) 2237-4951 (033) 2236-9465 +91 94332 79918 +91 33 2237-3106

Safescrypt Digital Signature Certificate (DSC) Application Checklist

No Particulars Required Checklist

1.

Certificate Application Form with Applicant Details a. Photo b. Sign across Photo & Form c. Sign on Form d. Valid e-Mail Address entered e. PAN entered (Mandatory for Class II Individual DSC) Photo ID & Address Proof of Certificate Applicant: Attestation Required by: 1. Self Attested AND 2. Banker/ Notary Public/ e-Commit Official (To bring original for verification) A. Photo ID Proof (ANY ONE* from below List) PAN Card (*Mandatory for Class II Individual DSC) Passport / Driving License / Voter ID / Aadhar Card B. Address Proof : should contain same current address as mentioned in Application Form (name on Address Proof should match with name on PAN Card for Class II Individual DSC) ANY ONE from Below List Passport / Driving License / Voters ID card / Ration Card / Aadhar Card Bank Statement attested by the bank within last 3 months Water / Gas / Electricity / Mobile / Telephone Bill within last 3 months LIC Paid Policy Receipt (Current Year) Property Tax/ Corporation/ Municipal Corporation Receipt Current Year SSC/HSC/Graduation/Post Grad.Degrees/School Leaving Certificate
Note: Only for Organisation based DSC, a single document (only from the list above) may be considered, if it contains both Photo & Address of the applicant. eg. Passport with both Photo & Address Pages.

Additional Documents for Organisation based DSCs

3.

Proof of Right (PoR) to do Business documents [Attested by Authorised Signatory with official seal ) Organisation Type Copies of Document Company Certificate of Incorporation OR (Pvt. Or Public Ltd.) Memorandum & Articles of Association (1st , 2nd & Last 3 pages attested) Partnership Firm Copy of Partnership Deed VAT / Service Tax / Sales Tax Registration Certificate OR Trade License OR Sole Proprietorship Last 2 years Income Tax Return & To Be Attested by both Banker PAN Card & & Authorised Signatory with Firms Bank Statement Official seal Registration Certificate OR Society / Trust / Rules / Bye Laws OR Association Memorandum of Association Submit above documents with cheque issued in favour of a) N. K. Poddar e-Comm IT b) We-Comm IT (Only Delhi Customers) Delivery shall be made only on clearance of the cheque. Draft / Cash is also accepted. Thanks & Regards, Bharat Poddar Partner & Business Head N. K. Poddar e-Comm IT

Digital Signature Certificate Subscription Form

Class of Certificate
Class 2 Class 3

Type of Certificate

Individual With Org Name

Signing Encryption

Certificate Validity

1 Year 2 Years

Section 1: Subscriber Details Name*:

Designation :
D D M M Y Y Y Y Date of Birth*: Gender *: Male Address (Residential address in case of Individual or Organization address in case of DSC with ORG )

Female

* Self Attested Photo

Organisation Name *
(Mandatory in case of ORG DSC)

Door No/Building Name * Road/ Street/ Post Office * Town/ City/ District * State/ Union Territory * Country*

: : : : : PIN Code*

Telephone Number* (with STD Code): : Mobile Number* Email id* : : Section 2: Identity Proof Details Photo Identity Proof* Identity Proof Name
( Eg: Pan Card, DL, Passport, ...)

Address Proof* Address Proof Name

( Eg: Passport, DL, Latest Telephone Bill, ...)

Identity Proof Number

Note*: Subscriber's signature should appear on the Photo ID Proof.

Section 3: Declaration
I hereby declare that all the information provided on this Subscription Form for the purpose of obtaining a digital certificate is true and correct to the best of my knowledge. I am aware, as a subscriber for a digital signature certificate, the duties and responsibilities are applicable under the IT Act, India and the SafeScrypt CAs CPS https://www.safescrypt.com/pdf/cps.pdf .

Signature of the Subscriber* Date*:

D D M M Y Y Y Y

Place*: Section 4: Authorisation (*only for ORG DSC)

Note*: Subscriber has to sign before the Authorised LRA/Partner for Class3 DSC.

I , _______________________________________________________ acknowledge by my signature, that the Subscriber information in this document is complete and accurate as per our office records. I fully understand that the Subscriber is responsible to transact on the Organisations behalf and I will ensure timely revocation of Digital Signature Certificate in case the employee leaves the company in future.

Signature & Organisation seal* For office use only Attestation By Sify Authorised LRA/Partner(*For Class3 DSC Only) I hereby declare that the subscriber has personally appeared before me and submitted the original document copies of ID proof. I have verified the same with TRUE COPY.
Signature and Seal * Date * D
D M M Y Y Y Y

Partner Name: Date of Issuance: City:

Name *

Note*: Safescrypt at its discretion, will make a telephone call to verify the details of the Subscriber.

SafeScrypt CA Services brought to you by: Sify Technologies Limited, 2nd Floor, Tidel Park, #4 Rajiv Gandhi Salai, Taramani, Chennai - 600113. E-Mail: enquiries@safescrypt.com