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APPLICATION FOR NATIVITY/RESIDENTIAL

CERTIFICATE

1 Name of Applicant
(Son/Daughter of

2 Address of the Applicant

3 Purpose for which Nativity/


Residential certificate is required

Signature of the Applicant

Village Office
.......................
No. Date ........................................

NATIVITY/RESIDENTIAL CERTIFICATE

Certified on enquiry that Smt./Sri ........................................................................................................


D/o.S/o ........................................................................................................................................................
......................................................................................................................................................................
................................................................................................................................................................
is a Native of /Permanent Resident of ..........................................................................................Village
.............................................................................. Taluk ........................................................... District
in Kerala State.
This certificate is issued to be produced before the ..................................................................

Village Officer
............................... Village

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