iia eae aan akon eel lant) Instruction: Al details tobe ile Bock eters (Tobe valid for 3 months rom dete of sue) Tobe printed on plain A& paper see; Not equed to be printed on letterhead; oy | Los Bory president [] Non-Resident nian (un) owenidnent’ [icant tages ar 3870 35693794 Fall Name: KUNTL SATNT oo: [DINESH SATNT House nosalde/ap: [ P-124, SECOND FLOOR _ ] street/ Road Lane: Lanark: NEAR CHoRCH ‘Area/ Locality/ Sector: EAST yENOD NAGAR Vilage Town/City PATPAR GANT aaa] peace PATPARGAN J Disa: EAST DELHT state: DELHT PIN code ies eae enki i Date of irth: 26 |Let {tar nar eee Certifier’s Details (To be filled by the certifier Only) Name of the Certfier: DEVENDRA KUMAR Designation: CouNCILLOR WARD 146 MAYOR VIHAR PuRse-9 cence 218 KHICHRI PUR UTLLAGE DELHE- lloo%) Contact Number: 981 93 0594 fy above mentioned details ofthe resident ‘Checklist for Ceifer ie eee ee) EXrooverming Frsuedaeisited resin’ sinatwe [gestiers deta 7 cmetted oftcer- Group Ta iken?s motos cross signe nd ces rps (pope phot or phot to oper [E1 Village Panchayat Head or Mukhiya 1 Garetted ofcer- Group 8 (wey may micr municipal Councitor Oy tehsitdar Ey Head of recognized Educational ntittion C1 superintendent/ Warden/ Matron/ Head of institution ‘of Recognized shalter homes/ Orphanages D1 erro officer Signature tarp ofthe Cetin ard No, 198, Mayot Vita ‘Municipal Corporation of ‘Tobe used as Proof of entity (Pc) onlin speic cases as mentioned in thelist of appliable supporting documents.