ANNEXURE 'A'

(Application form for permission to consult records)

To

The Director-General,
Archives Department,
Haryana, Panchkula.

Sir/ Madam,

I hereby apply for enrolment as a research scholar for consulting records in the Research Room of the Haryana State Archives. I agree to comply with the rules and conditions in force and promise to deposit a copy of each of my work based on the materials consulted at Haryana State Archives immediately after the publication.

1. Name, including Surname:
2. Father's/ Husband's Name:
3. Date of Birth:
4. Qualification:
5. Nationality:
6. Profession:
7. Subject of Research:
8. University/ Institutions* registered with:
9. Period for which admission is sought:
10. Signature and date:
11. Address

(i) Local: (ii) Permanent:

Particulars of records to be consulted:

* Scholars are requested to attach a letter of recommendation from their University/ Institution/ Department. However, the foreign scholars are requested to bring a letter of accredition from the diplomatic representatives of their country in India as well.