1.His present occupation is 2This certificate being granted only for the purpose of Designation (with seal of office) Signature of the applicant Office of theMiscellaneous Certificate Case Noof (Year)This is to certify that Shri/Smt./Missson / daughter / wife of Shriis a resident of Village/TownP.S.Tahasilin the District ofin the State of Orissa.Date: Please affix required stamps before submission(See Rule 3) FORM NO.II APPLICATION FOR IDENTITY CERTIFICATE 20Signature of Revenue Officer Published on National Portal of India (india.gov.in) (DD/MM/YYYY)Government of OrissaRevenue & Disaster Management Department
