Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

Annexure I

(Residence/Domicile Certificate Format)


This Certificate has to be submitted at the time of Counseling (if applicable)

No.:

Date :

...................................

Residence / Domicile Certificate


This is to certify that Sri/Smt .......................................... ..................................................
Son/Daughter Sri/Smt ................................................................................................Residing
at ......................................... ...........................................
has Domiciled/Resided in the State of Karnataka for the last ..........................................
..(in figures and words) years and ...................................... months.
This Certificate is issued for ............................................................. purpose.

Place:..
Tahsildar____________________________
Date:
Taluk_______________________________

You might also like