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    Digital Signature Certificate Subscription Form

    Uploaded by

    Divya Aggarwal
    This document is a digital signature certificate subscription form for obtaining a 1-year or 2-year certificate. It collects subscriber details like name, address, identification proofs. For an organization certificate, an authorized person needs to acknowledge the subscriber's details. The subscriber declares that the information provided is true and correct. On approval, the authorized local registration authority will issue the digital signature certificate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Digital Signature Certificate Subscription Form

    Uploaded by

    Divya Aggarwal
    114 views1 page
    This document is a digital signature certificate subscription form for obtaining a 1-year or 2-year certificate. It collects subscriber details like name, address, identification proofs. For an organization certificate, an authorized person needs to acknowledge the subscriber's details. The subscriber declares that the information provided is true and correct. On approval, the authorized local registration authority will issue the digital signature certificate.

    Original Description:

    dsc form

    Original Title

    new form

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    This document is a digital signature certificate subscription form for obtaining a 1-year or 2-year certificate. It collects subscriber details like name, address, identification proofs. For an organization certificate, an authorized person needs to acknowledge the subscriber's details. The subscriber declares that the information provided is true and correct. On approval, the authorized local registration authority will issue the digital signature certificate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    114 views1 page

    Digital Signature Certificate Subscription Form

    Uploaded by

    Divya Aggarwal
    This document is a digital signature certificate subscription form for obtaining a 1-year or 2-year certificate. It collects subscriber details like name, address, identification proofs. For an organization certificate, an authorized person needs to acknowledge the subscriber's details. The subscriber declares that the information provided is true and correct. On approval, the authorized local registration authority will issue the digital signature certificate.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Digital Signature Certificate Subscription Form

    Class 2 Individual Signing 1 Year


    Class of Certificate Type of Certificate Certificate Validity
    Class 3
    With Encryption 2 Years
    Org Name
    Section 1: Subscriber Details

    Name*:

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


    Identity Proof Name Address Proof Name
    ( Eg: Pan Card, DL, Passport, ...) ( 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*:
    Note*: Subscriber has to sign before the Authorised LRA/Partner for Class3 DSC.
    Section 4: Authorisation (*only for ORG 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 Partner Name:
    original document copies of ID proof. I have verified the same with TRUE COPY.
    Date of Issuance:
    Signature and Seal *

    Date * D D M M Y Y Y Y Name * City:


    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

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