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No.

: ……………………

NATIVITY CERTIFICATE

Certified that Shri./Smt./Kumari. ……………………………………..

Son/Daughter of ………………............………………………..

………………………. House ……...............……………………….. Kara

………………………………… Village, ……………….......………………..

Taluk is a native of ……………………………. District, Kerala State and

that he/she is a Citizen of India.

This certificate is issued for producing before the

……………………………………………………………………………

Place :

Date :
(Seal)

Designation & Signature.


Court Fee
Stamp

From

…………………………………………….
Son/Daughter of ………………………….
…………………………….. House,
……………………………….. Kara
……………………………….. Village
……………………………….. Taluk
……………………………….. District.

To

………………………………

………………………………

Sir,

Please be kind enough to issue me a Nativity Certificate to be produced

before the …………………………………………………………………………...

………………………………………………………………………………………

for ………………………………………………………………………………….

………………………………………………………………………………………

Yours faithfully,

Place :

Date :

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