KPSIAJ Membership Update Form

Membership Update Application

Apart from the mandatory fields, please fill in all the fields where an update of information is applicable.
Name*

Full NameSurname
Father Name*

Full NameSurname
Father Alive*

YesNo
Mother Name*

Full NameSurname
Mother Alive*

YesNo
Husband Name

Full NameSurname
Husband Alive

YesNo
Is your CNIC prepared?*

YesNo
CNIC*
Type 13 digit CNIC. In case of less than 18 years check the number from B-Form
CNIC Front

In case of age less than 18 years attach B-Form image
Cancelof
CNIC Back

In case of age less than 18 years attach B-Form image
Cancelof
B-Form

Cancelof
JCIC
Type 16-digit JCIC.
Current Jamaat Card Status*
Specify information that needs to be corrected on card

Duplicate Card Payment

Online amount transfer confirmation
Please transfer Rs. 200 in following account and either paste text from transaction email or upload account transfer confirmation image (along with transaction reference number)

In case you are submitting card renewal requests for more than one members, you can make one consolidated account transfer (number of forms x 200) and attach same evidence on all forms.

Bank: Habib Metropolitan Bank Limited, IBB - Soldier Bazar Branch, Karachi.

Title of Account: KHOJA (PIRHAI) SHIA ISNA ASHERI JAMAAT

Account No: 6-99-98-29319-714-100261

IBAN: PK85 MPBL 9998 7371 4010 0261

Note : In case where card renewal request is submitted without online payment, printing of card will remain on hold till receiving of payment.
Are you transferring online?

YesNo
Online transfer confirmation

TextScreenshot
Amount transfer confirmation text
Copy complete text along with reference number from your confirmation email.
Amount transfer confirmation image

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Information to be updated

Picture
SMS / WhatsApp / Email*

YesNo
Cell Phone 1 (WhatsApp enabled)*
Please enter cellphone number along with country code
Picture

Female picture must be in Islamic Hijab. Please provide a recent photograph. Use Portrait image. Front pose only, pictures with side pose not acceptable.
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Disability (If Any)*

YesNo
Please specify the type of disability
Disability Certificate

Cancelof
If you want to update any of the following click Next else Click Submit to Submit the form.
- Marital Status
- Contact Information
- Blood Group
- Address

Information to be updated

Marital Status
Change marital status
Leave empty if no change is required.
Reference document for Marital Status Change

In case of marital status change, a documentary proof confirming the change is necessary.
Cancelof
If you want to update any of the following click Next else Click Submit to Submit the form.
- Contact Information
- Blood Group
- Address

Information to be updated

Contact Information
Cell Phone 2
Please enter phone number along with country code
Tel. No. (Res)
Please enter phone number along with country code
Tel. No. (Off)
Please enter phone number along with country code
Email Address
example@example.com
If you want to update any of the following click Next else Click Submit to Submit the form.
- Blood Group
- Address

Information to be updated

Blood Group
Blood Group
Blood Group Report

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If you want to update residential address please click Next else Click Submit to Submit the form.

Information to be updated

Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Utility Bill

Image of utility bill is required for verification of address.
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Should be Empty:

Membership Update Application