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GOVERNMENT OF ANDHRA PRADESH

REVENUE DEPARTMENT

No. PAP151601001194 Date: 25.07.2012

FAMILY MEMBER CERTIFICATE

Sub:- Issue of Family Membar Certificate in respetct in respect of ( Late )


Sri.Sambangi Srinivas. S/o. S. Dhanunjaya Rao. R/o: Plot No.320
Sriramnagar Colony Puppaguda Sub:-Village --Expired on 22.05.2012
--F. M.C. Issued --Reg

Ref:- 1) A/o. Smt. Sambangi Hemalatha W/o. Late S. Srinivas


2) Report of M. R. I. No.2854/12 date: 22.06.2012

On the strength of the report of the Spl.R.I. of this Mandal and the documentary
evidence submitted by the petitioner along with petition it is certified that (Late)
Sri. Sambangi Srinivas. S/o. S. Dhanunjaya Rao. R/o: Plot No. 320.
Sriramnagar Colony Puppaguda Sub:-Village --expired on 22.05.2012.
leaving behhind the following family members.
SI. Relationship with Age Martial Status
Name
No. decansed
1. S.Hemalatha Wife 33 Widow
2. S.Keerthana Daughter 08 Minor

MANDAL REVENUE OFFICER


RAJENDRANAGAR MANDAL
RANGAREDDY DIST.

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