APPLICATION FOR NATIVITY/RESIDENTIAL CERTIFICATE 1 Name of Applicant (Son/Daughter of 2 Address of the Applicant 3 Purpose for which Nativity/ Residential certificate is required Signature of the Applicant Village Office ....................... No. Date ........................................ NATIVITY/RESIDENTIAL CERTIFICATE Certified on enquiry that Smt./Sri ........................................................................................................ D/o.S/o ........................................................................................................................................................ ...................................................................................................................................................................... ................................................................................................................................................................ is a Native of /Permanent Resident of ..........................................................................................Village .............................................................................. Taluk ........................................................... District in Kerala State. This certificate is issued to be produced before the .................................................................. Village Officer ............................... Village
