Family Level Data Collection Form for Annapurna Yojana PDF: Download & Step-by-Step Fill-Up Guide

The Government of West Bengal has structured the application process for the Annapurna Yojana (Annapurna Bhandar) around the household unit. While digital applications are accepted via the Social Registry portal, citizens lacking internet access or attending local outreach camps must submit the physical Family Level Data Collection Form for Annapurna Yojana.

This official 11-page booklet captures comprehensive demographic, asset, and banking data to determine a household’s eligibility for the ₹3,000 monthly financial assistance. This guide provides the official PDF download link, critical rules for Head of Family (HOF) nomination, and a section-by-section breakdown of how to correctly fill out the offline application form.

Annapurna Yojana Offline Form: Quick Information

Download the Official Family Level Data Collection Form PDF

District administrations (such as North 24 Parganas) have issued official notices providing the standard application booklet. You can download and print the 11-page PDF using the official links provided below:

• Download PDF: Family Level Data Collection Form for Annapurna Yojana (English/Bengali) PDF
• Official District Notice: North 24 Parganas Administrative Notice

Critical Rules Before Filling the Family Level Data Collection Form

Before you start filling out the Family Level Data Collection Form for Annapurna Yojana PDF, keep these administrative rules in mind to prevent rejection:

1. Use Block Letters: If filling out the English version, write clearly in BLOCK CAPITALS using a blue or black ballpoint pen.
2. Joint Family Assessment: The form is “Family Level.” If you live in a joint family and cook meals in a shared kitchen, all members must be listed on a single form under one Head of Family (HOF).
3. Single Bank Account Rule: The bank account provided for the female applicant must be an individual (single-holder) account, strictly in her name, and actively mapped for Direct Benefit Transfer (DBT).
4. Page 11 Restriction: Do not write anything on Page 11. It is strictly reserved for Data Entry Operators and field verification officers.

Step-by-Step Guide to Filling the 11-Page Family Level Data Collection Form

Pages 1 & 2: HOF Details & Family Roster

1.Establish the Head of Family (HOF):

• Write the full name of the family head exactly as it appears on their Aadhaar card.
• Enter their Date of Birth (DD-MM-YYYY) and select their gender.
• Provide the HOF’s Aadhaar number (e.g., [Aadhaar Number]) and Digital Ration Card ID.
• Enter the complete permanent residential address and an active, Aadhaar-linked mobile number.

2.Enumerate Family Members:Mark ‘YES’ only for the eligible female applicant.

• List all household members in the rows provided (Member 1, Member 2, etc.).
• For each member, provide their Name, Date of Birth, Gender, Relationship to the HOF, and Aadhaar number.
• Crucial Step: In the column labeled “Applying for Annapurna Yojana”, mark “YES” exclusively for the eligible adult woman (aged 25-60). Leave it blank for males and children.
• Note on Children: For children under 5 who do not have an Aadhaar card, write “NA” in the Aadhaar column.

Pages 2 & 3: Banking and Electoral Information

• Bank Account Details: Provide the Bank Name, Account Number, and IFSC Code for the HOF and all adult members. The female applicant’s account must be verified as DBT-linked.
• Voter ID (EPIC) Data: Enter the EPIC number for every adult (18+). You must also provide the Assembly Constituency (AC) and electoral Part Number, which can be found on election voting slips.

Pages 3 to 5: Assets, Ration, and Insurance

• Digital Ration Card: Select your card category (AAY, PHH, SPHH, RKSY-I, or RKSY-II) and indicate if your family regularly draws monthly rations.
• Property & Vehicles: Declare whether your house has more than three pucca rooms. If the household owns land, write the total area in decimals as per recent land records (RoR). Disclose if anyone owns a non-commercial motorized four-wheeler.
• Health Insurance: If the family has a Swasthya Sathi Card, select “Government Insurance”, write Swasthya Sathi, and list ₹5 Lakh as the sum assured.

Pages 6 to 9: Income, Employment, & Social Declarations

• Employment & Tax: Mark the employment sector for each adult. Housewives should be marked as “Unemployed” or “Others”. Declare if any member pays Income Tax or Professional Tax (which is an exclusion criterion). Provide PAN numbers for those who hold them.
• Existing Government Schemes: If the applicant currently receives benefits like Lakshmir Bhandar via DBT, declare it. The benefit will transition to the enhanced ₹3,000 tier once this new registry form is approved.
• Statutory Checkboxes: Declare if any member holds a constitutional post or receives a government pension. For sections regarding CAA applications or SIR 2026 tribunals, general citizens without active tribunal cases should check “Not Applicable”.

Page 10: Declaration & Signatures

Section H contains the legal consent and declaration.

• Review all entered information against your photocopied documents.
• Check the consent box agreeing to the verification of your family data.
• Authorized Signatory: The declaration must be signed or thumb-printed strictly by the Head of the Family (HOF). The female applicant does not sign unless she is also the designated HOF.

Documents to Enclose with the Offline Form

You must attach self-attested photocopies of your documents to the back of the completed Family Level Data Collection Form.

Learn More: Ensure your documents meet all official criteria by reviewing theComplete Checklist of Annapurna Yojana Required Documents.

Submission at Duare Sarkar Camps & Next Steps

1. Submit the Booklet: Take the completed 11-page form and the stapled document photocopies to your local Duare Sarkar camp, Gram Panchayat office, or BDO welfare desk.
2. Collect Acknowledgment: The receiving officer will tear off, sign, and stamp the Acknowledgment Slip at the bottom of the booklet. Keep this slip safe.
3. Track Your Application: Once the block data entry operator digitizes your physical form, you can track its progress online. Use the Application ID on your slip or your mobile number on the socialregistry.wb.gov.in portal.

Learn More: Experiencing delays after submitting your form? Read our guide onHow to Perform an Annapurna Bhandar Status Check.

Important Links: Annapurna Yojana Form & Portal

Frequently Asked Questions (FAQs)