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Addrass Update Form1

This document is a certificate for Aadhaar enrolment or update, serving as proof of address. It includes details of the resident, such as name, Aadhaar number, and address, as well as information about the certifier. The certificate must be filled out in block letters and is valid for three months from the date of issue.

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singhnigam100
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62 views1 page

Addrass Update Form1

This document is a certificate for Aadhaar enrolment or update, serving as proof of address. It includes details of the resident, such as name, Aadhaar number, and address, as well as information about the certifier. The certificate must be filled out in block letters and is valid for three months from the date of issue.

Uploaded by

singhnigam100
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE (TO BE USED ONLY AS PROOF OF ADDRESS*)

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

To be printed on plain A4 paper size; Not required to be printed on letter head; 0 1 0M 2 M 2 0 2 5


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

Aadhaar Number: 7 0 8 6 1 9 1 6 9 1 4 1
(For update only)

Full Name: TANU GAUR

C/o: KULDEEP SENGAR

House No./ Bldg./ Apt: -

Street/ Road/ Lane: -

Landmark: -

Area/ Locality/ Sector:

Village/ Town/ City: GRAM PATARAHI

Post Office: GRAM PATARAHI MADHAUGARH

District: JALAUN
Resident’s Recent
State: Colour Photograph
UTTAR PRADESH
3.5cm x 4.5 cm

Cross Signed and


Cross Stamped
by the Certifier.

PIN Code: 2 8 5 1 2 4 NB: DO NOT


OVERLAP WITH
TEXT BOXES
Signature of the Resident/
Date of Birth: 0 6 0 2 1 9 9 9 Thumb/ Finger Impression

Certіfіer’s Details (To be fіlled by the certіfіer Only)


Name of the Certifier: MAHENDRA SINGH

Designation: GRAM PRADHAN

Office Address: PATRAHI JALAUN

JALAUN

Contact Number: 9 5 6 8 5 0 1 5 7 0

I hereby certify above mentioned details of the resident Checklist for Certifier
and I am a.... (Tick appropriate box below) No overwriting Issue date is filled Resident’s signature Certifier’s details
Gazetted Officer - Group A Resident’s Photo is cross signed and cross stamped (paper to photo or photo to paper)

Village Panchayat Head or Mukhiya


Gazetted Officer - Group B
MP/ MLA/ MLC/ Municipal Councillor
Tehsildar
Head of Recognized Educational Institution
Superintendent/ Warden/ Matron/ Head of Institution
of Recognized shelter homes/ Orphanages
Signature & Stamp of the Certifier
EPFO Officer

*To be used as Proof of Identify (PoI) only in specific cases as mentioned in the list of applicable supporting documents.

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