Scribd
Upload
1K views2 pages

CDMA Birth Corrections Application Form Birth Details

The document is a form for applying for corrections to birth details registered with the CDMA Birth Corrections Application. It requests information about the registrant such as name, date of birth, gender, parents' names, birth place and addresses. It also requests details of the informant assisting with the application and documents required to be submitted with the application such as the original birth certificate, declaration by parents, notary affidavit and other supporting documents.

Uploaded by

abc xyz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
1K views2 pages

CDMA Birth Corrections Application Form Birth Details

The document is a form for applying for corrections to birth details registered with the CDMA Birth Corrections Application. It requests information about the registrant such as name, date of birth, gender, parents' names, birth place and addresses. It also requests details of the informant assisting with the application and documents required to be submitted with the application such as the original birth certificate, declaration by parents, notary affidavit and other supporting documents.

Uploaded by

abc xyz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

CDMA Birth Corrections Application Form

Birth Details:-
District: __________________________ Registration Unit Id: _____________________________________

Registration Number: _______________ Registration Year: _____________ Birth Year: _________________

Location:  Greater Municipality  Municipality  Municipal Corporation  Gram Panchayat

Gender: Male Female

Corrections Required in Birth Certificate Details:-

Whether You Want to Update Child Name:  Yes No

Correct Child Surname: ___________________ Correct Child Name: _____________________________

Whether You Want to Update Date of Birth: Yes No

Correct Date of Birth: _________________________

Whether You Want to Update Gender: Yes No

Correct Gender: Male Female

Whether You Want to Update Father Name: Yes No

Correct Father Surname: ____________________ Correct Father Name: ___________________________

Whether You Want to Update Mother Name: Yes No

Correct Mother Surname: ___________________ Correct Mother Name: ___________________________

Whether You Want to Update Birth Place: Yes No

Correct Birth Place: ___________________________

Whether You Want to Update Address at the Time of Birth: Yes No

Correct Line 1 of Address at the Time of Birth: _________________________________________________

Correct Line 2 of Address at the Time of Birth: _________________________________________________

Correct Line 3 of Address at the Time of Birth: _________________________________________________

Whether You Want to Update Permanent Address: Yes No

Correct Line 1 of Permanent Address: ________________________________________________________

Correct Line 2 of Permanent Address: ________________________________________________________

Correct Line 3 of Permanent Address: ________________________________________________________

Informant Details:-
Informant Name: _________________________________________________________________________

Informant Relation: S/o  D/o  w/o  H/o  M/o  F/O  C/o

Informant Address1: ______________________________________________________________________

Informant Address2: ______________________________________________________________________

Informant Address3: ______________________________________________________________________

Mobile Number: ____________________ Email ID: ______________________________________________

Remarks: _______________________________________________________________________________

Pin code: ___________________ Delivery Type: Manual / In Person  Post – Local  Post - Nonlocal

Purpose of the Certificate ___________________________________________________________________

No of copies: ________________

Document List:-

1. Application Form* Applicant’s Signature

2. Original Birth Certificate issued by the Registrar of Birth

3. Declaration by Parent(s) attested by two gazetted officers

4. Notary Affidavit on Rs.10/- Non-Judicial Stamped paper

5. Available Documentary evidences like educational certificates, Election ID Card, Ration Card, Passport,

Driving License and Marriage certificates

6. A letter from the Hospital Authorities where the Birth has occurred

Note: Please upload Application Form and any one of Above Documents as a single file in pdf format

You might also like