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(Chairman / Commissioner Pad)

Family Certificate
Date of issue ………

This is to certify that the family of...........................Consists of the following


members:

SL NAME RELATION DATE PRESENT PERMANENT


NO OF ADDRESS ADDRESS
BIRTH

01 NAME HUSBAND … … …
S/O, (FATHER
NAME)

02 NAME WIFE … … …
D/O, (FATHER
NAME)

03 NAME SON …. …. ……
S/O,
(FATHER
NAME)

04 NAME DAUGHTER … … …
D/O,
(FATHER
NAME)

They are Bangladeshi by birth and well known to me. Their moral characters are
good and have a good relation with each other.

I wish them bright and happy life.

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