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Correction Forms

The document is an application form for corrections of birth or death entries in the Nellore Municipal Corporation. It requires details about the declarant, the event, existing entries, and necessary supporting documents for the correction process. Additionally, it mandates declarations from gazetted officers and various forms of identification and evidence to validate the request for correction.

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653 views2 pages

Correction Forms

The document is an application form for corrections of birth or death entries in the Nellore Municipal Corporation. It requires details about the declarant, the event, existing entries, and necessary supporting documents for the correction process. Additionally, it mandates declarations from gazetted officers and various forms of identification and evidence to validate the request for correction.

Uploaded by

officemannar
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
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NELLORE MUNICIPAL CORPORATION

APPLICATION FOR CORECTIONS OF BIRTH / DEATH ENTRIES

I …………………………………………………………

S/o.W/o…………………………………………… aged about ……… years , working as

………………………………………………………………………

(Designation & office Address) , residing at

…………………………………………………………..

(Complete address with Door No) declare that :

1. The place of Birth of the child / death of deceased at

…………………………………

………………………….(Actual place of event ) on ………………..(date of the event)

2. The Birth / Death Certificate issued

on………………………………………………………..

3. The name/s was wrongly informed by

……………………………………………………….

(the person who informs the event has to be stated) and do the

following :

Existing entries To be corrected as

(If in case of Birth) (If in case of Death)

Name of the father: Name of the declarant:


Signature of the father: Relation with the deceased:
Name of the mother: Signature of the declarant:
Signature of the mother: Date:
Date: (P.T.O)

I know Sri/ Smt.

………………………………………………………………………………………………………

S/o,W/o……………………………………………..................., resident of

………………………….. ……………………………………….…………………… The

signature of the declarant is taken in my presence and the content mentioned by

the declarant are true and correct to the best of knowledge and belief.

1 2.

GAZETTED OFFICER GAZETTED OFFICER


(With seal) (With seal)
Name of the Officer: Name of the Officer:

CSC Transaction No. CSC Transaction No.

The following documents should be produced by the declarant for name


correction in Birth/ Death registers :
1.Declaration by the nearest relative( Parents/Spouse)
2. The declaration stated should be true and correct by two Gazetted Officers
(Names of Gazetted Officers are to be written in CAPITAL).
3. Notary Affidavit on Rs.10/- Non Judicial Stamped Paper.
4. The Original Birth/Death certificate already taken, are to returned.
5. Documentary evidence like Educational certificates, Election ID Card, PAN
Card, Rational Card, Passport, Driving License, Marriage Certificate, LIC
Polices, Caste Certificate, Property papers etc.
6. Consent Letter from the Hospital Authorities regarding correction to the effect
If the event occurred at Hospital
7. Other Child Certificates if any
8. In case Medico Legal Death a) FIR b) Post Mortem Report c) From-2
concerned Police Station
9. Any other support documents if any please specify.

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