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Office of Tehsildar
Rot 1: G.R.P.& S.D. No.1586/34-D, Dated 17.5.1961
Ref 2: G.R.GAD No, Mis.31/76-Desk ool, Dated 25 8.1977
Rof 3: aufican git taal, 1087/9696/ 608 - 32. Dated 2.1.1969
Serial No; 40764019507
District: Chandrapur
Certificate of Age, Nationality and Domicile
(Issued by Authorities in the State of Maharashtra)
‘On submission of the proofs noted below, itis hereby certified that, Kumar saikrushna narayan mane.
R/O shengaon, Vilage Shengaon, Tehsil Jiwati, District Chandrapur was born on 05/07/2013 (Fifth of
July in the year Two Thousand and Thirteen) at Shengaon, Tehsil Jiwati, District Chandrapur in the
‘State of MAHARASHTRA’ within the teritory of INDIA and he is a CITIZEN OF INDIA antias domiciled in the
‘State of Maharashtra.
PARTICULARS OF PROOFS SUBMITTED
1. Bonafide certiicato
2. Ration Card
3. Birth Certificate
4. mesidionce of sachiv
5. adharkard
8. Bhade pawati
7. adhar of father
8. rahivashi savghoshnapaty
9. savghoshmapatr
‘Signature vaio
Digaly Sige by
v Ce)
Dare OME 2020 8.21: PM
Place: Tahsildar Jivati
Date : 0203/2020
Printed By -OMTID: VLE Name Tahsiddar Jiwal, Date:02/03/2020 4:20PM.
‘This 6 @ digitally signed document, hence is legaly vad as por the lnormation Technology (IT) Act 2000
“To vey vt ntpestwwa mabaoriine gov n/Verty OR SMS “WHespace>CSCeapaci>-VRFY-<20 dig Barcode number” to 106 tema BSNL. MTL. Tata Mable and
51960 from others.
