This certificate being granted only for the purpose of Signature of Revenue Officer District (with seal of office) Signature of the applicant Office of the Miscellaneous Certificate Case No. of 20This is to certify that Shri/Smt./Missson / daughter / wife of Shri is a native of the District of in the State of Orissa and he/his family ordinarily resides in Village/TownP.S. Tahasil in the District of Date:(See Rule 3) FORM NO. III Please affix required stamps before submissionFORM FOR RESIDENT OR NATIVITY CERTIFICATE Government of OrissaRevenue & Disaster Management Department Published on National Portal of India (india.gov.in)
