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Irfana

The document contains a form for a resident or non-resident Indian to fill out personal details, including name, address, and date of birth. It also requires certification from a designated official, providing their details and signature. The form includes a checklist for the certifier to ensure all necessary information and documentation are provided.

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raj sahil
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1K views1 page

Irfana

The document contains a form for a resident or non-resident Indian to fill out personal details, including name, address, and date of birth. It also requires certification from a designated official, providing their details and signature. The form includes a checklist for the certifier to ensure all necessary information and documentation are provided.

Uploaded by

raj sahil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
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Aaa eee Ae ee sl) ratuciions: Al details to be filled in Block Leters 19 te pinteaionpian a4 poper ste Pree ot required tobe rinteaon eter neo (7o be wad for 3 more from date of sue) os t 2) [ee 4 A residen Non-Resident indian (NA New Enver THodate Reavest Sorunioe rit 24 pig “Fees tae Full Name: TREANA HASAN ele: Ptwte zamaR pe pT] Houseno/side/ant: 14938 -39 fiat wo. 8, 2°" look Street/ Road/ Lane: Ghe zamtk wert landevare: NAwAe Gans Areo/tocatty/ seer: TA LAD MARKET wh Village/Town/ ci: DELHT PHAR Barve Post office: Ddtenz hfo- District: NoRTH DELHT State: SE mt ow Teel ie Date of birth os |Los |L14 26 | norris non Certifier’s Details (To be filled by the certifier Only) tameotthecenife: [PAR L pp 6) NG H S#PHWEY Designation: ML A Ase) Zio Oftce aaaress: (8 ASH OKA APARTMENT TF RAT PUR RORD C/VIL LINE DELHI] Yoo SG Contact Number: GID 20 C COOK thereby certify above mentioned details ofthe resident ‘and | am a... (Tick aporopriate box below) 1 Gazetted officer Group a ‘checkilst for certiier tfoovewiting (Gur dateis tes [2 fesiden’s senate EACErte’s duis fesdlents Photos eras sentd ancierass stamped [naner to phato-r ahatota poner) (FJ Vilage Panchayat Head or Mukhiva Gazetted offcer- Group 8 ‘MP/ MILA MLC Municipal Coundlor tohstdar [F] ead of Recognized tsucatonal insttution superintendent! Warden/ Matron/ Head of istution ot Recognized sheer homes/ Orohanaees 1 erro omcer Sigatwe & Stamp ol he certs “ote wee as Pr0ot ot Kenny (Po only in specie cases 35 Mentioned in Melis of sppiezble umpertg document.

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