FORM No. IV[See Rule 3]Office of the Miscellaneous Certificate Case No. of 20 (year) APPLICATION FOR LEGAL HEIR CERTIFICATE This is to certify that the person/persons specified below is/are the legal heir/heirs of late Shri/Smt son/ daughter/wife of Shri of Village/Town P.S Tahasil in the district of in the State of Orissa. 2. This certificate is being granted only for the purpose of Name Relationship with the Deceased1.2345Signature of the Revenue OfficerDateDesignation (with seal of office)Signature of the Applicant (s)Revenue & Disaster Management DepartmentGovernment of Orissa Published on National Portal of India (india.gov.in)
