Who Should the BVC Be Addressed To in Pariksha DGCA for computer number? Need Help!

Filling out the Karnataka marks card verification form but unsure what to enter. What should go in 'Type of Organization,' 'Organization Name,' 'Requester Name,' and 'Requester Address' if verifying my own marks card? Anyone who has done this before, please help!, also which one would be better , if i address it to myself what should i enter in the section of organization name.