Indian Register Data Entry - Amendments

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PROTECTED A 

1. Registered Individual Affected (Complete this section for ALL amendments)
   
   
   Registration No.

   ___________________________________
   
   
   Family Name

   ___________________________________
   
   
   Date of Birth (YYYYMMDD )

   ___________________________________
   
   
   Given Name(s)

   ___________________________________
   
   
    
   
   
2.  Amend Register Page (Complete only the fields in which there are changes)
   
   
   Family Name

   ___________________________________
   
   
   Given Name(s)

   ___________________________________
   
   
   Date of Birth (YYYYMMDD )

   ___________________________________
   
   
   Gender

   Ο   Male     Ο   Female
   
   
   Category

   ___________________________________
   
   
   Birth Name

   ___________________________________
   
   
   Alias

   ___________________________________
   
   
   Province of Residence

   ___________________________________
   
   
   Residence Code

   ___________________________________
   
   
   Reserve No.

   ___________________________________
   
   
   Date of Death (YYYYMMDD )

   ___________________________________
   
   
   Acquired Status by Marriage

   Ο   Yes     Ο   No
   
   
    
   
   
3.  Amend Father Information (Complete only the fields in which there are changes)
   
   
   Registration No.

   ___________________________________
   
   
   Family Name

   ___________________________________
   
   
   Birth Name

   ___________________________________
   
   
   Given Name(s)

   ___________________________________
   
   
   Gender

   Ο   Male    Ο   Female
   
   
   Date of Birth (YYYYMMDD )

   ___________________________________
   
   
   
    
   
    
4.  Amend Mother Information (Complete only the fields in which there are changes)
   
   
   Registration No.

   ___________________________________
   
   
   Family Name

   ___________________________________
   
   
   Birth Name

   ___________________________________
   
   
   Given Name(s)

   ___________________________________
   
   
   Gender

   Ο   Male    Ο   Female
   
   
   Date of Birth (YYYYMMDD )

   ___________________________________
   
   
   
    
   
   
5.  Amend Spouse Information

   Ο Current     Ο Historical
   
   
   
   
   
   Registration No.

   ___________________________________
   
   
   Gender

   Ο   Male    Ο   Female
   
   
   Date of Birth (YYYYMMDD )

   ___________________________________
   
   
   Birth Name

   ___________________________________
   
   
   Family Name

   ___________________________________
   
   
   Given Name(s)

   ___________________________________
   
   
   Date of Marriage (YYYYMMDD )

   ___________________________________
   
   
   Date of Divorce (YYYYMMDD )

   ___________________________________
   
   
   _____   Delete Marriage
   
   
    
   
   
6.  
   Amend Event (IRAs with Data Entry Only)

   From Registration No.
   (New)

   To Registration No.
   (Original)
   ___ Reverse a Band Transfer
   
   

    
   
   

    
   ___ Reverse New Registration No.

    
   
   
   ___ Correct Child's Band Affiliation

   New Band Code
   
   

   New Registration No.

   
   

INTER 83-070E 2012-04-01