CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE (TO BE USED ONLY AS PROOF OF ADDRESS*)
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 be printed on letter head; D D M M Y Y Y Y
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
State: Colour Photograph
3.5cm 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/ Finger Impression
Certіfіer’s Details (To be fіlled by the certіfіer Only)
Name of the Certifier:
Designation:
Office Address:
Contact Number:
I hereby certify above mentioned details of the resident Checklist for Certifier
and I am a.... (Tick appropriate box below) No overwriting Issue date is filled Resident’s signature Certifier’s details
Gazetted Officer - Group A Resident’s Photo is cross signed and cross stamped (paper to photo or photo to paper)
Village Panchayat Head or Mukhiya
Gazetted Officer - Group B
MP/ MLA/ MLC/ Municipal Councillor
Tehsildar
Head of Recognized Educational Institution
Superintendent/ Warden/ Matron/ Head of Institution
of Recognized shelter homes/ Orphanages
Signature & Stamp of the Certifier
EPFO Officer
*To be used as Proof of Identify (PoI) only in specific cases as mentioned in the list of applicable supporting documents.
