1253230106 5003982481
Office of Tehsildar Atpad
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-xxxdl, Dated 25.8.1 977
Ref 3: o1f L YfAwdiewet 1087/9698/608-32. Dated 2.1.1989
Serial No 43005101903
District Sangli
Certificate of Age, Nationality and Domicile
(lssued by Authorities in the State of Maharashtra)
On submission of the proofs noted below, it is hereby certified that, Mr. Kamble Ulhas Uday RIO
Atpadi, ilage Atpadi, Tehsil Atpadi, District Sangli was born on 03/10/2004 (Third of October in the year
Two Thousand and Four) at Kolhapur (Municipal Corporation.), Tehsil Karvir, District Kolhapur in the
State of MAHARASHTRA' within the teritory of INDIA and he is a CITIZEN OF INDIA andas domiciled in the
State of Maharashra.
PARTICULARS OF PROOFS SUBMITTED
R.No.9571
1. School Leaving CertificateShri Bhavani Vidyalaya,Atpadi
2. Rahivashi Dakhala Dt-06/01/2023
3. Ration Card WK 445028
4. Aadhar Card 8452 4377 5332
Dt-06/01/2023
5. Application Form
eecutiee Magis
t Signature valid
Digitally Signed By BAI SAR RAO MANE
(PERSONAL)
Date: 10-Jan-20 7 0 IST
Tehsildar
Place Atpadi
Date 10/01/2023 Atpadi
Printed By-OMTID : VLE Name :Ekatmik Nagari Suvida Kendra Setu Atapdi, Date:10/01/2023 5:27PM
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