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Office of Tahasildar Khalapur

Ref 1:G.R.P.& S.D. No.1586/34-D, Dated 17.5.1951
Ref 2:G.R.GAD No. Mis.31/76-Desk-oodl, Dated 25.8.1977
Ref 3: gn.fa.AL.qfaosuAt. 1087/9698/608-32. Dated 2.1.1989

Serial No 41756054746
District : Raigarth

Certificate of Age, Nationality and Domicile

(lssued by Authoritles in the State of Maharashtra)
On submission of the proofs noted below, it is hereby certified that, Ms
Vllage Khopoli, Tehsil Khalapur, District Raigarh was born Shweta Shirish Sardar RIO.,
on 13/08/1994 (Thirteenth of August in the
year One Thousand Nine Hundred and Ninety Four) at
the State of MAHARASHTRA within the territory of INDIA and Khalapur, Tehsil Khalapur, District Raigarth in
she is a CITIZEN OF INDIAandas domiciled in
the State of Maharashtra.

PARTICULARS OF PROOFS SUBMITTED

1. Birth Certificate
2. Electricity Bill
3. Ration Card
4. School LeavingCertificate
5. Self Declaration
6. Copy Of Adhar Card

CCUTIVE Signature valid

Place
MAGISTRATR Digitaly Si ed by
SìDH KRRATHOD
Date:20-05-11 12:05:40 PM

Khalapur APUR RAIGAO

Date : 10/05/2023 Executive Magistrate
Khalapur

Pnmed By -OMD:VLE Name Tahasii Khalanur Setu,

his is a digitally signed document, hence is
Date:10/05/2023 5:35PM
legally valid as per the Infomation
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