APPLICATION FOR THE GRANT OF DOMICILE CERTIFICATE IN DELHI 1. Name in BLOCK letters: ___________________________________________________ 2. Address: _________________________________________________________________ 3. Police Station _____________________________________________________________ 4. Place & Date of Birth ______________________________________________________ 5. Nationality _______________________________________________________________ 6. Name of Father/Husband ___________________________________________________ 7. Address of Father: if living (otherwise last address) _____________________________ 8. The year & the date from which he/she is residing in Delhi _______________________ 9. Have you obtained a domicile certificate from any other place. If yes, give reasons for applying Domicile Certificate from Delhi. _____________________________________ 10. Give details by which you claim yourself to a domicile of Delhi: (a) Ownership of immovable property in Delhi. Details and when purchased including number, etc. (b) Continuos residence in Delhi for the last 3 years Details: (c) Educational certificates with proof and one institution where studied. Whether owner/partner of a firm, etc. 11. Reasons for obtaining Domicile Certificate: ____________________________________ 12. Ration Card (with original if called for):_______________________________________ Signature Name & Address
