Þ¼ð¢ð¤ìê¢ ê£ù¢ø¤î¿è¢è£ù õ¤í¢íð¢ðð¢ ð®õñ¢

APPLICATION FORM FOR RESIDENTIAL CERTIFICATE

1. õ¤í¢íð¢ðî£óó¤ù¢ ªðòó
Name of the Applicant:

2. îèð¢ðù£ó¢ / èíõó¢ ªðòó¢

Father/Husband’s Name:

3. Ýí¢‡/ ªðí¢‡
Sex (M/F) :

4. Þ¼ð¢ð¤ì ºèõó¤
Residential Address :

5. °´ñ¢ð Ü좬ì âí¢‡.

(ïèô¢ êñó¢ð¢ð¤è¢è «õí¢´ñ¢)
Ration Card No.
(Copy to be enclosed)

6. ð÷¢÷¤ ÞÁî¤ õ°ð¢¹ê¢ ê£ù¢ø¤îö¢ âí¢.

(ïèô¢ êñó¢ð¢ð¤è¢è «õí¢´ñ¢)
School Leaving Certificate
(Copy to be enclosed)

7. ªðø¢«ø£ó¢è좰 îñ¤ö¢ï£ì¢®ô¢ à÷¢÷

ܬêò£ê¢ ªê£î¢¶ õ¤õóñ¢ îè¢è ê£ù¢ÁèÀìù¢
(Details of immovable property of the parents
in Tamil Nadu with necessary documents)

8. õ¤í¢íð¢ð ï£÷¢
Date of application :

õ¤í¢íð¢ðî£óó¤ù¢ ¬èªò£ð¢ðñ¢
Signature of the Applicant