Price:l

Application Form
Late Reristration of Birth

To
Offoer.
The Reveye Divisional Divisios,.

Respected Sit,
Cenificate of my sonsdaughter-regarding.
Sub: Reques for lssue of the Birh
DIO
sIo/ / FIO/ MIO / WIO katne, enkotaduon
. AOe (iuonsh Rio HNo. 2-\usRNenr
Age6 years, ocoupatikm:
Mandal, Sa Strsaa lo_Dist. Andbra Pradesh submit the folowring few line
Annodacua, consideratioa plense.
favorable
for your kind perusal and sy1npathetic
years ad my sosuught
Delivery t
Was bom on (ddimnlyyyy) in
Mandal/Municipality. Anavtapooaf.
H.No. New Anodasu was not iaformed tu th
information regardiog birh of my ntdaoghter
Andhta Pradesh. The
Authorty
oAMadauMandal/Municipaliry Hence the
local Bids and Deaths Registration Register uf
is he Barth & Death
not recaorded in the
narne of ny so fdaghter
Mandal/Mupicipelity
educatiod urgently
bith cenificate for further
That my ondaughter requires
GP or Mune pa!
avaiability ceniticate 155cd bs chc
Iencloed hert with Non
marks re io and Self Affiavt
Coromissioner. Ration card cogy. SSC
MuHicipal
neceasuy orders to CommsSIORer.
Therefore Irequest you kandly to issue isue Birth Ceruticte
brth y sJaughier and
of
CouncitAnAdngusg record datc
above us the eadie.

ContacDatnlls Yours fathfuliy, -

Landline Number:
Mobile No:
E-Mail iD: Signatue of the Appicart

ProcedurR: o cdns ta hasndosnd)

1) Physlical Delamant Commissloner#
Issued by the GP or Munlcipal
2) Nom vellablty cerifcate
3)Ration card capy
)$SC rcs eme
5) Set Affidavit
datory #any ne of them