Page 1 of 1

The applicant has to submit verification letter in the prescribed format from any one of the following :-

z Gazetted Officer
z Member of Parliament (MP)
z Member of legislative Assembly (MLA)
z Chairman, Zila Panchayat
z Chairman, Nagar Panchayat
z Branch Manager, Nationalised Bank

- -

1.
2. (/ / ./ .)*
3. / / (//./.)*

4. (/ .)*
5. ......./......./..............
6.
7. *

8.
9. ........... ............
10.
11.
?
12. ?

file://E:\Share\htmlpages\certDomicil[1].html 2/23/2012