GOVERNMENT OF KARNATAKA

ONLY FOR BIRTH VERIFICATION PURPOSE

This is to certify that the following information has been taken from the original record of birth which is the register for
Belgaum (M Corp. + OG) (village/town) of Belagavi taluk of Belagavi district of Karnataka State
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Name KESHAV KUMAR Sex Male

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Corp. +
Date of Birth Place of Birth
OG),Belagavi,Belagavi,Karnataka

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Name of Mother SHRUTI CHETAN Name of Father CHETAN NAVALAGATTI

NAVALAGATTI
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Address of parents at the Belagavi., Permanent address of At- Davalatti, Post- Akkatangerhal,
time of birth of the child: Belagavi,Belagavi,Karnatak parents: Gokak, Gokak,Belagavi,Karnataka
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 £lisxSĥcx‘lÍ 803033/U/B/2017/005096  £lisxSĥŸeĸsCh 26/12/2017
Registration No.: Date of Registration:
 bªe ©e`ƒ¡eT\h6SÅĹÐ As per Affidavitdt 02/12/23  VΨePVQÎĪsģS 04/12/2023
Remarks(if any) Ĩ£exB
Date of Approval
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Signature of Issuing Authority Address of the issuing authority

Belagavi, Belagavi Taluk, Belagavi District

Digital Signed YES