1. CertifiCate of address
TO WHOMSOEVER IT MAY CONCERN
This is to certify that Shri/Smt. _________________________________________________
C/o S/o D/o W/o Shri. ________________________________ (D.O.B. _______________)
Residing at House/ Bldg./ Apt: __________________________________________________
Street/ Road/ Lane: _________________________ Landmark: ________________________
Area/ Locality/:____________________ Village/ Town/ City __________________________
P.O___________________________________ District: _____________________________
State: ________________________________ Pin Code _________________ is known to
me for the last _________Year/s.
This certificate is being given to the individual for
Enrolment in ________________________
Updating in Adhaar No: _____________________________
(Tick whichever is applicable)
Signature of the officer
(MP or MLA or Gazetted Officer or Tehsildar)
Seal
Date: Signature of applicant
Note: To be printed on Government Letter Head only.
Photo Graph
Attested by the
Officer