Government of Goa

OFFICE OF THE MAMLATDAR OF BICHOLIM TALUKA, BICHOLIM-GOA

Address:Multipurpose Building,First Floor,Opp.Chhatrapati Shivaji Maidan,Bicholim-Goa-403504
Office Phone No:0832-2362237 Email :mam-bicholim.goa@nic.in
Certificate No.: BIC1204214464 Date: 15-Apr-2021
Read :-
Office Memorandum No.:14/59/2017-RD/1746 dated:31/08/2018 by Revenue Department.

RESIDENCE CERTIFICATE
This is to certify that Mr. Vijay Channapa Hallikeri age 24 years, son of Channapa Hallikeri
presently residing at H.No. H NO.-- situated in ward/road Vathadev, town/village Sarvan, Taluka
Bicholim for 15 years. Further the applicant was resident of Bicholim Taluka for 15 years. He has
produced Residence Certificate bearing No 0505171719 dated 10-May-2017, issued by the
Mamlatdar Of Bicholim Taluka. Hence he is/was resident of state of Goa for 15 years.

This certificate has been issued solely based on documents and the declaration given by the applicant
and that the applicant shall be solely responsible for any false declaration and face the consequential
penal action if any.

This certificate is issued at the request of Mr. Vijay Channapa Hallikeri .

This certificate is valid for 3 years from the date of issue.

( Pravinjay Pandit )
Place:- Bicholim-Goa
MAMLATDAR OF BICHOLIM TALUKA
Approval Date:- 15-Apr-2021 Bicholim-Goa

Digitally signed by

PRAVINJAY GURUDAS PANDIT

Mamlatdar
Office of Mamlatdar
4/15/2021 2:23:14 PM

This certificate is digitally signed and can be verified on www.goaonline.gov.in