12532112062003456988
Office of Tehsildar Achalpur
Ref 1: G.R.P.& S.D. No.1586/34D, Dated 17.5.1951
Ref 2: G.R.GAD No. Mis.31/76Deskxxxll, Dated 25.8.1977
Ref 3: शा.िन.सा.प.िव.क.डीएमसी.1087/9698/ 608 32. Dated 2.1.1989
Serial No : 40042227017
District : Amravati
Certificate of Age, Nationality and Domicile
(Issued by Authorities in the State of Maharashtra)
On submission of the proofs noted below, it is hereby certified that, Mr. Mohammad Mohsin Abdul
Shakil R/O Sailani Plot, Paratwada, Village Paratwada, Tehsil Achalpur, District Amravati was born on
15/04/1997 (Fifteenth of April in the year One Thousand Nine Hundred and Ninety Seven) at
Paratwada, Tehsil Achalpur, District Amravati in the State of 'MAHARASHTRA' within the territory of INDIA
and he is a CITIZEN OF INDIA and has domiciled in the State of Maharashtra.
PARTICULARS OF PROOFS SUBMITTED
1 . UID
2 . Ration Card
3 . School Leaving Certificate
4 . DECLARATION
5 . BIRTH PLACE AFFIDAVIT
6 . RESIDENT PROOF
Digitally Signed by
Ganesh M. Sanghare
Date:2021-12-07 1:45:15 PM
Place : Achalpur Tehsildar
Date : 07/12/2021 Achalpur
Printed By OMTID :MH050200442 VLE Name :Mohammad Izhar Abdul Qadeer, Date:07/12/2021 12:18PM
This is a digitally signed document, hence is legally valid as per the Information Technology (IT) Act, 2000.
To verify visit https://www.mahaonline.gov.in/Verify OR SMS “MH<space>CSC<space>VRFY<20 digit Barcode number>” to 166 from a BSNL, MTNL, Tata Mobile and
51969 from others.
