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    Adobe Scan 08 Sept 2022

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    Rajesh Kushwaha
    This document is a certificate for Aadhaar enrolment or update. It contains instructions for filling out resident details such as name, address, date of birth, and Aadhaar number if applying for an update. It also contains a section for the certifier's details, where the certifier must fill their name, designation, office address, and contact number. The certifier confirms the resident's details and signs and stamps the certificate, certifying that the resident's photo is cross-signed to the paper.

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    Adobe Scan 08 Sept 2022

    Uploaded by

    Rajesh Kushwaha
    218 views1 page
    This document is a certificate for Aadhaar enrolment or update. It contains instructions for filling out resident details such as name, address, date of birth, and Aadhaar number if applying for an update. It also contains a section for the certifier's details, where the certifier must fill their name, designation, office address, and contact number. The certifier confirms the resident's details and signs and stamps the certificate, certifying that the resident's photo is cross-signed to the paper.

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    This document is a certificate for Aadhaar enrolment or update. It contains instructions for filling out resident details such as name, address, date of birth, and Aadhaar number if applying for an update. It also contains a section for the certifier's details, where the certifier must fill their name, designation, office address, and contact number. The certifier confirms the resident's details and signs and stamps the certificate, certifying that the resident's photo is cross-signed to the paper.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    218 views1 page

    Adobe Scan 08 Sept 2022

    Uploaded by

    Rajesh Kushwaha
    This document is a certificate for Aadhaar enrolment or update. It contains instructions for filling out resident details such as name, address, date of birth, and Aadhaar number if applying for an update. It also contains a section for the certifier's details, where the certifier must fill their name, designation, office address, and contact number. The certifier confirms the resident's details and signs and stamps the certificate, certifying that the resident's photo is cross-signed to the paper.

    Copyright:

    © All Rights Reserved
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    of 1

    CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE

    Instructions: All details to be filled in Block Letters (To be valid for 3 months from date of issue)

    To be printed on piain A4 poper size; Not required to print on letter head;


    7 o 2] |2 o 22
    Resident's Details
    Resident Non-Resident Indian (NRI) New Enrolment
    Update Request
    Aadhaar Number:
    (For update only) 2 12 Y 85 o3S1
    Full Name:
    GAURAy KANT

    c/o: HAJARI
    House No./ Bldg./ Apt:

    Street/ Road/ Lane:

    Landmark:

    Area/ Locality/Sector:

    Village/Town/ City: BHoPUR hOA2I DPUR


    Post Office:
    AGNER
    District:
    LAGRA
    State:
    UITAR PRADESH
    9oyS2yyo8
    PIN Code:
    283115S rounaVKant
    Signature of the Resident/
    Date of Birth: Thumb/ Finger Impression

    Certifier's Details (To be filled by thecertifier Only)


    Name of the Certifier

    Designation: 9e}1)77

    office Address: 37PKT

    Contact Number: y33 24 240


    Checklist for Certifier
    resident
    Ihereby certify above mentioned details of the kertifier's details
    and 1 am a... (Tick appropriate box below) 9Wo avenwriting Ssue date isfiHed Resident's signature
    Resident's Photo is cross signed and cross stamped (paper to photo or photo to paper)
    Gazetted Officer -Group A
    Village Panchayat Head or Mukhiya

    Gazetted Officer- Group B

    MP/MLA/ MLC/ Muncipal Councilor


    Tehsildar MTHT T
    Head of Recognized Educational Institution v e 7 , aTTT
    Superintendent/ Warden/ Matron/ Head of Institution
    of Recognized shelter homes/ Orphanages Signature & Stamp of the Certifier

    EPFO Officer
    documents at Sl. Nos. 13
    Nos. 17, 20, 21, 22, 31 & 32; POA documents at SI. Nos. 23, 24, 37, 38, 44 & 45; POR
    R 4noB dppicable for Pol documents at SI. amended trom ule Lo u
    814 DOB documentsat St. Nos 4,5,14 &15 ofSchedule ll of the Aadhaar (Enrolment and Update) Regulations, 2016, as

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