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Certificate For Aadhaar Enrolment/: Certifier's Details (To Be Filled by The Certifier Only)

This document is a certificate for Aadhaar enrolment or update. It contains fields for the resident's details such as name, address, date of birth and photograph. It also contains fields for the certifier's details such as name, designation, office address and contact number. The certifier must check boxes to indicate their role from a list of authorized roles like gazetted officer or village head. They must also sign, stamp and cross-sign the resident's photograph to validate the certificate.

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Attala Narasingha Rao
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7K views1 page

Certificate For Aadhaar Enrolment/: Certifier's Details (To Be Filled by The Certifier Only)

This document is a certificate for Aadhaar enrolment or update. It contains fields for the resident's details such as name, address, date of birth and photograph. It also contains fields for the certifier's details such as name, designation, office address and contact number. The certifier must check boxes to indicate their role from a list of authorized roles like gazetted officer or village head. They must also sign, stamp and cross-sign the resident's photograph to validate the certificate.

Uploaded by

Attala Narasingha Rao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE

Instructions: All details to be filled in Block Letters (To be valid for 3 months from date of issue)

To be printed on plain A4 paper size; Not required to print on letter head

Resident's Details

Resident Non-Resident Indian (NRI) New Enrolment Update Request

Aadhaar Number:
(For update only)

Full Name:

C/o:

House No./ Bldg./ Apt:

Street/ Road/ Lane:

Landmark:

Area/ Locality/ Sector:

Village/ Town/ City:

Post Office:

District:
Resident's Recent
Colour Photograph
State: .Scm x 4.5 cm

Cross Signed and


Cross Stamped
by the Certifier.

PIN Code: NB: DO NOT


OVERLAP wITH
TEXT BOXES
Signature of the Resident/
Date of Birth:
Thumb/FingerImpression

Certifier's Details (To befilled bythe certifier Only)


Name of the Certifier:

Designation:

Office Address:

Contact Number:

Ihereby certify above mentioned details of the resident Checklist for Certifier
and I am a.... (Tick appropriate box below) No overwriting Issue dateisfilled Resident's signature Certifier's details
Gazetted Officer- Group A Resident's Photo is cross signed and cross stamped (paper to photo orphoto to paper)

Village Panchayat Head or Mukhiya


Gazetted Officer - GroupB
MP/ MLA/ MLC/ Muncipal Councilor
Tehsildar
Head ofRecognized Educational Institution

Superintendent/ Warden/ Matron/ Head of Institution


of Recognized shelter homes/ Orphanages
Signature & Stamp of the Certifier
EPFOofficer
NOTE: This format is applicable for POl documents at SI. Nos. 17, 20, 21, 22, 31& 32; POA documents at SI. Nos. 23, 24, 37, 38, 44 & 45; POR documents at Sl. Nos. 13
& 14 bOB documents at SI. Nos. 4, 5, 14 & 15 of Schedule ll of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.

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