12532312142005186740
Tahsil Office, Haveli
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 : 419351168036
District : Pune
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, Kumar Shivam Shankar
Suryavanshi R/O wagholi, Village WAGHOLI, Tehsil Haveli, District Pune was born on 15/02/2007
(Fifteenth of February in the year Two Thousand and Seven) at Naykalwadi, Tehsil Walwa, District
Sangli 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 . Electricity Bill
3 . Ration Card
4 . School Leaving Certificate
5 . Birth Certificate
6 . CPL
7 . Application Form
Digitally Signed by
KIRAN MAGAN SURAVASE
Date:2023-12-26 9:55:13 PM
Place : Haveli Tahsildar
Date : 22/12/2023 Haveli
Printed By OMTID : VLE Name :SWAPNIL SANJAY MAGAR, Date:22/12/2023 2:08PM
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.
