Grievancce Redress Form

Entries Prefixed with * are Mandatory!

*Please Select the Department
*Please Select a/an
*Please Enter your Name
Male    Female    Others(If not an Individual)    Transgender
*Please Select a Complainant Category
Yes    No

*Password must contain at least one number
*Password must contain at least one lowercase-letter letter
*Password must contain at least one uppercase-letter letter
*Password must not be empty
*Password length must be between 6-10 characters
(Password must be at least 6 characters, at most 10 characters,at least one lower case letter,one upper case letter and one number)
*Password does not match

Address of Correspondence

*Please Enter Address
*Please Enter a Valid Pincode
*Please Select a Country
*Please Select a State/UT
*Please Select a District
*Please Enter your mobile number *Invalid Mobile Number
*Invalid Email ID

Complaint Details

Please Enter Complaint Details before submitting the Grievance Form
Yes    No   
*Please Select a choice
*Please Enter Ration card No.
*Please Enter FPS Name
*Please ID/License No.
*Please Select FPS Disrict
*Please Enter Village/Locality
Issued By NFSA  Others   
*Please Enter your Grievance
*Please Suggest a Remedial Action
for .pdf/.jpg, file size should be less than 1MB.
for .mp4 file size should not exceed 5MB
*File size exceeds 1MB
Yes    No

*Click Here to resend the security code
*Please Enter the Security Code sent to your mobile
*Security Code cannot be empty
*Note: Please Click the 'Validate' Button to Validate your Data before clicking the 'Final Submit' Button
Form Contains Errors, Please Recheck the form Data Validated, You can click the 'Final Submit' Button to submit your Grievance