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sencnoentre G2@ | = sc axpnann ance DELVE OF THANCAL AND OTHER SURGE, BERETS AND SERWCES) ACT, 201 ate A) "AADHAAR ENROLMENT/ UPOATE FORM (CHILD5-38 years) tence ofon the structions ove while ing up the form Use Copter on inrolment (CI Update HEeeanr one nin (™T 5 Jaasia ofupine hadhasr Nomber(UDE CET CLT Cor Z Teen reac rte Figen] Neble(] Brie of Bti—JAdtrent—] Name) conde ea TE document updete. C1 Language only Updste e | Rane [as pec OV/POR docurient): $j Bath Reptration Number(s per the ith Cerca with Namek: {brtvectieate wth mare 9 228y fs...” snot allowed) © Sencer =] Male (J Female (_] Trongencer Tlie ves OR Daerah: TT Cavproximate (7) declared [] verified 5-1 Ht Bae ene TOT ORd MOIST fo RE trod aa bereation Dan of he orn aed Mother's Name enn mmmothersadhear NOLL CIOL} CLI Fathers Name : 7 * Father’ Aadhaar No TI CET thease anyone of parent inet avaiable, reson thereof | SSS SSS SS EESSE poorer sha evento ont mst fur ets of Achar murder of porents wherever avaiable, Aagna2r | Sasertaton by eps eae | pease both of parents ae not availabe, reason thereof: | | Guardian's Name: acc "guardian's Auhost Nox CII} CITI CLIT | Sic names efi anions ore 1 ron Bob duth Cerfcate (with Name) issued by | | b-PO\/ FORA DOB: Passport [] Any PORdocument as per tit I Competent Authority Birth certificate with name as |_| Nome of the document “Baby one” na lowed) asspoa Number: THOF/Guardian snot avaiable and write names of document produced as 7 | Document based Envoime POL ede eh nnn POM ae 1 008 ott: ‘adres Cfo tame-opborl : || [House Ne.r bide ant: E Bireet/Road/iane! | | Pacman ward Areal ocliySec0% | | [tae Town Cr Post Offcel Mandatory Dat Sabi ate |_| Teme: Mobis No Fin Code ander ‘ao Bemopraphiy Document updst [rte Names ofthe docoment Refer UIDAI web for ist of documents) 2 PO rade et BFR mtg €.__DOB jowe of rnd d.__ POR (root Relationship | 7 Thereby give my consent for sharing information of the child/ward and supperting documents with government agencies for wth a Information a: prerequisite for generation /updating of Aadhaar. rah reat eer apoae "roost ety torn the llr eet ce Bama may be prod to anager ey wh conser srr du sin mp so eo ts pina eer os Be a ey erat aoa e Fhe cntrm atm te parertuain fhe dua wich x eso Se rf Jeri of the chiar nt wish to pve my Aadaarautheniain forthe purpose of eroing/updting the Anca of "herby confemthat the normstion/cocumens seine are covet othe best ol my noe sd beRt am any pol ftine any of the sad information 'slundtebelncrectudet/ase eal acton may bese pant; 95 per the provslon he Aa nb eerecreses ec a pe the Aodhade Ae 2006 (38 of 2006) nd equations ames Vet’ Stamp and Signature: Signature of Parent/Guardian ‘wren nego rw by oe ‘eset ans reer a per Selon 31) he ADGA At. Incas of Rien Frege, septate tor abe ved. ema Scanned with CamScanner

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