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CERTIFICATE FOR AADHAR ENROLMENT /UPDATE

Instructions: (To be valid for 3 months from date of issue) Date:

To be printed on plain A4 paper size ; Not required to print on letter head; As details to be filled in Block Letters

Resident’s Details
Resident Non-Resident India (NRI) New Enrolment Update Request

Aadhaar Number Resident’s Recent Colour Photograph


(For update only) Cross Signed and Cross Stamped by the Certifier

Resident’s Name
Full Name:

C/o:

House No./Bldg./Apt:
Street/Road/Lane:
Landmark:
Area/Locality/Sector:
Village/Town/City:
Post Office:
District:
State:
PIN Code:
Signature of the Resident/Thumb/
Finger Impression
Date of Birth:

To be filled by the certifier Only


I hereby certify above mentioned details of the resident
All details to be filled in Block Letters
Certifier’s Details
Name of the Certifier:
Designation:
Address:

Contact Number:
I, the certifier, am: (Please tick appropriate box below)

Gazetted Officer – Group A Gazetted Officer – Group B

Village Panchayat Head or Mukhiya MP/MLA/MLC/Municipal Councilor

Tehsildar Head of Recognized Educational Institution

Superintendent/Warden/Matron/Head of Institution of Recognized shelter homes/Orphanages

Signature of the Certifier Stamp of the Certifier


NOTE: This format is applicable for POI document at Sl. Nos. 17, 20, 21, 22 & 31; POA documents at Sl. Nos. 23, 24, 37, 38 & 44; POR documents at Sl. Nos. 13 &
14 DOB documents at Sl. Nos. 4, 5 & 14 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.
CERTIFICATE FOR AADHAR ENROLMENT /UPDATE

Instructions: (To be valid for 3 months from date of issue) Date: 2 4 1 2 2 0 1 9


To be printed on plain A4 paper size ; Not required to print on letter head; As details to be filled in Block Letters

Resident’s Details
Resident Non-Resident India (NRI) New Enrolment Update Request

Aadhaar Number Resident’s Recent Colour Photograph


(For update only)
8 4 8 3 8 0 5 5 2 4 5 4 Cross Signed and Cross Stamped by the Certifier

Resident’s Name
Full Name: P R I Y A N K A R A N I

Resident’s Address
C/o: V I K A S

House No./Bldg./Apt: H N O 7 5 / 2 - 6
Street/Road/Lane: P A T T I K A L A N
Landmark:
Area/Locality/Sector: S H A L I M A R C O L O N Y
Village/Town/City: A M B A L A C I T Y
Post Office: A M B A L A C I T Y
District: A M B A L A
State: H A R Y A N A
PIN Code: 1 3 4 0 0 3
Signature of the Resident/Thumb/
Finger Impression
Date of Birth: 1 1 0 7 1 9 9 4

To be filled by the certifier Only


I hereby certify above mentioned details of the resident
All details to be filled in Block Letters
Certifier’s Details
Name of the Certifier:
Designation:
Address:

Contact Number:
I, the certifier, am: (Please tick appropriate box below)

Gazetted Officer – Group A Gazetted Officer – Group B

Village Panchayat Head or Mukhiya MP/MLA/MLC/Municipal Councilor

Tehsildar Head of Recognized Educational Institution

Superintendent/Warden/Matron/Head of Institution of Recognized shelter homes/Orphanages

Signature of the Certifier Stamp of the Certifier


NOTE: This format is applicable for POI document at Sl. Nos. 17, 20, 21, 22 & 31; POA documents at Sl. Nos. 23, 24, 37, 38 & 44; POR documents at Sl. Nos. 13 &
14 DOB documents at Sl. Nos. 4, 5 & 14 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.
CERTIFICATE FOR AADHAR ENROLMENT /UPDATE

Instructions: (To be valid for 3 months from date of issue) Date: 2 4 1 2 2 0 1 9


To be printed on plain A4 paper size ; Not required to print on letter head; As details to be filled in Block Letters

Resident’s Details
Resident Non-Resident India (NRI) New Enrolment Update Request

Aadhaar Number Resident’s Recent Colour Photograph


(For update only)
8 2 3 0 7 6 4 9 6 1 1 5 Cross Signed and Cross Stamped by the Certifier

Resident’s Name
Full Name: P R I Y A N K A

Resident’s Address
C/o: V I S H A N T

House No./Bldg./Apt: H N O 7 5 / 2 - 6
Street/Road/Lane: P A T T I K A L A N
Landmark:
Area/Locality/Sector: S H A L I M A R C O L O N Y
Village/Town/City: A M B A L A C I T Y
Post Office: A M B A L A C I T Y
District: A M B A L A
State: H A R Y A N A
PIN Code: 1 3 4 0 0 3
Signature of the Resident/Thumb/
Finger Impression
Date of Birth: 3 0 0 9 1 9 9 2

To be filled by the certifier Only


I hereby certify above mentioned details of the resident
All details to be filled in Block Letters
Certifier’s Details
Name of the Certifier:
Designation:
Address:

Contact Number:
I, the certifier, am: (Please tick appropriate box below)

Gazetted Officer – Group A Gazetted Officer – Group B

Village Panchayat Head or Mukhiya MP/MLA/MLC/Municipal Councilor

Tehsildar Head of Recognized Educational Institution

Superintendent/Warden/Matron/Head of Institution of Recognized shelter homes/Orphanages

Signature of the Certifier Stamp of the Certifier


NOTE: This format is applicable for POI document at Sl. Nos. 17, 20, 21, 22 & 31; POA documents at Sl. Nos. 23, 24, 37, 38 & 44; POR documents at Sl. Nos. 13 &
14 DOB documents at Sl. Nos. 4, 5 & 14 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.
CERTIFICATE FOR AADHAR ENROLMENT /UPDATE

Instructions: (To be valid for 3 months from date of issue) Date: 1 6 1 2 2 0 1 9


To be printed on plain A4 paper size ; Not required to print on letter head; As details to be filled in Block Letters

Resident’s Details
Resident Non-Resident India (NRI) New Enrolment Update Request

Aadhaar Number Resident’s Recent Colour Photograph


(For update only)
6 9 3 0 3 7 5 6 6 7 7 3 Cross Signed and Cross Stamped by the Certifier

Resident’s Name
Full Name: S A N T O S H

Resident’s Address
C/o: O M K A R

House No./Bldg./Apt: 3 9 - 4 0
Street/Road/Lane: N A Y A G A O N
Landmark: K H A S R A 1 9 / 2 1 / 1
Area/Locality/Sector:
Village/Town/City: A M B A L A C I T Y
Post Office: A M B A L A C I T Y
District: A M B A L A
State: H A R Y A N A
PIN Code: 1 3 4 0 0 3
Signature of the Resident/Thumb/
Finger Impression
Date of Birth: 2 0 0 1

To be filled by the certifier Only


I hereby certify above mentioned details of the resident
All details to be filled in Block Letters
Certifier’s Details
Name of the Certifier:
Designation:
Address:

Contact Number:
I, the certifier, am: (Please tick appropriate box below)

Gazetted Officer – Group A Gazetted Officer – Group B

Village Panchayat Head or Mukhiya MP/MLA/MLC/Municipal Councilor

Tehsildar Head of Recognized Educational Institution

Superintendent/Warden/Matron/Head of Institution of Recognized shelter homes/Orphanages

Signature of the Certifier Stamp of the Certifier


NOTE: This format is applicable for POI document at Sl. Nos. 17, 20, 21, 22 & 31; POA documents at Sl. Nos. 23, 24, 37, 38 & 44; POR documents at Sl. Nos. 13 &
14 DOB documents at Sl. Nos. 4, 5 & 14 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.
CERTIFICATE FOR AADHAR ENROLMENT /UPDATE

Instructions: (To be valid for 3 months from date of issue) Date: 1 6 1 2 2 0 1 9


To be printed on plain A4 paper size ; Not required to print on letter head; As details to be filled in Block Letters

Resident’s Details
Resident Non-Resident India (NRI) New Enrolment Update Request

Aadhaar Number Resident’s Recent Colour Photograph


(For update only)
5 6 3 5 1 7 1 9 3 2 0 0 Cross Signed and Cross Stamped by the Certifier

Resident’s Name
Full Name: O M K A R

Resident’s Address
C/o: P U R A N L A L

House No./Bldg./Apt: 3 9 - 4 0
Street/Road/Lane: N A Y A G A O N
Landmark: K H A S R A 1 9 / 2 1 / 1
Area/Locality/Sector:
Village/Town/City: A M B A L A C I T Y
Post Office: A M B A L A C I T Y
District: A M B A L A
State: H A R Y A N A
PIN Code: 1 3 4 0 0 3
Signature of the Resident/Thumb/
Finger Impression
Date of Birth: 1 9 7 4

To be filled by the certifier Only


I hereby certify above mentioned details of the resident
All details to be filled in Block Letters
Certifier’s Details
Name of the Certifier:
Designation:
Address:

Contact Number:
I, the certifier, am: (Please tick appropriate box below)

Gazetted Officer – Group A Gazetted Officer – Group B

Village Panchayat Head or Mukhiya MP/MLA/MLC/Municipal Councilor

Tehsildar Head of Recognized Educational Institution

Superintendent/Warden/Matron/Head of Institution of Recognized shelter homes/Orphanages

Signature of the Certifier Stamp of the Certifier


NOTE: This format is applicable for POI document at Sl. Nos. 17, 20, 21, 22 & 31; POA documents at Sl. Nos. 23, 24, 37, 38 & 44; POR documents at Sl. Nos. 13 &
14 DOB documents at Sl. Nos. 4, 5 & 14 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.

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