rea eee LEU eee Inconel oe edn oc ters (ibe vel for ror from doe fs) Tate pred onplon Ad popes; Notreuted to print on itera Resident Non Reaent indian (NR) New tnvolment Updite Request Andina Number (Fer usdste ony cle: House No./ Bldg./ Apt: Street/ Road/ Lane: Landmark ‘Area/Locality/ Sector: Village/ Town/ Cy: Post office: Distr: ese’ acne state: Gor Poet ‘Sem x45 em bythe corer PIN Code: na:oo wor Date of Birth: Seed ete Qe eck ke Name ofthe Cortiier: Designation: Office Address: Contact Number: | hereby certify above mentioned detals ofthe resident ‘Checklist for Corifier and | ar ai (Tec oppropriat box Blom) Llriooverwniting Cisvediteistites C] esisersstnsture C]certers deal Gazetted Offcer Group A resident's Phat is cross sgned and cross stomped fpaer to phat ar photo ta paper village Panchayat Head or Mokiya Gazetted Officer - Group 8 MP/ MUAY MLC/ Muncipal Councilor Tebsildar Head of Recognized Ecveational Institution Superintendent/ Warden/ Matron Head of Institution (ef Recognized shelter homes/ Orphanages PFO Officer oo0o00000 o NOTE: This formats applicable for POI documents 2S Nos.17, 20, 21,22, 31 & 32; POA documents at Sl. Nos 23,24, 37,38, 44 8 45; POR documents 3 Nos. 13 {444 B08 documents 3S Nos. 4,5, 14 15 of Sehecua ofthe AadraarfEnrlmant and Updst)Ragulators, 2016, a amend fem sim to tne.