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National Informatics Centre

Internet Services

Internal Documents

Government of India

Department of Information Technology, MCIT

NATIONAL INFORMATICS CENTRE

Application for E-Mail/Auth [Tick √ ] account for a single user

(Please read the instructions given in the reverse of this page; The completed application form, duly signed by

the concerned Project Coordinator /HOD of the concerned NIC Cell, should be submitted to Support Center at

“iNOC, NIC, A4B2 Bay, A-Block C.G.O. Complex”) . Please use CAPITAL LETTERS.

1) Name of the applicant*: ___________________________________________________

(Dr./Mr./Ms.

First name Middle Name

Surname)

2) (a)Date of Birth:_______________ (b)Designation*:_____________________________

3) Min./Dept./Org*: ___________________________________________________________

4) Address for correspondence*:_______________________________________________

________________________________City:______________ Pin Code: _____________

5) Telephone Number :(O)*_____________(R)_____________Mobile*:________________

6) Preferred Email/Auth id**: a) _____________________________

b) ____________________________________________________

7) Alternate e-mail address for correspondence*: ___________________________

8) Date of Retirement/Date of Completion of Contract (

Contractual employees/Consultants)

(DD/MM/YYYY)* ____________________________________________

declare

agree

This is to

that I have read the terms and conditions and I

to abide by them.

Signature of Competent

Signature of the Applicant

Authority of the Department

with date and seal

Account Category:

Free/ Paid

If free, on What Basis:______________________________

If paid, Project No. :________________________________

Signature of NIC Coordinator/HOD

with date and seal

Name & Designation:_______________________________

E-mail and Tel.____________________________________

FOR OFFICE USE

Billing Division(RR Section):

File Number:

Payment Processed: Yes/ No

Signature

User ID Creation:

Assigned login ID:_______________________Domain:______________

Signature of iNOC incharge

Remarks(BO/PO):_______________________________________

Signature of the Operator

Name& Desig.:__________________________

* Entries are mandatory and need to be filled.

**The login ids will be generated based on the existing email address policy.

https://mail.nic.in/docs/NIC_Policy_on_format_of_e-mail_Address.pdf

** Please check the policy

**A suffix may be added to make the email id uniq across the domain

Release Page 1of 2

NIC-INOC-Internet Services

Version 7.1.5

Application For E-Mail/auth Account For A Single User - Government Of India Department Of Information Technology, Mcit

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