1952041731253600172195
1952041731253600172195
1952041731253600172195
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Office of Tahasildar, Panvel
Ref 1: G.R.P.& S.D. No.1586/34D, Dated 17.5.1951
Ref 2: G.R.GAD No. Mis.31/76Deskxxxll, Dated 25.8.1977
Ref 3: शा.िन.सा.प.िव.क.डीएमसी.1087/9698/ 608 32. Dated 2.1.1989
Serial No : 41736089232
District : Raigarh
Certificate of Age, Nationality and Domicile
(Issued by Authorities in the State of Maharashtra)
On submission of the proofs noted below, it is hereby certified that, Mr. KHEMA RAM JANGIR R/O c
wing 403, plot no 09 sector 36, nandanvan park, Village Kamothe, Tehsil Panvel, District Raigarh was
born on 17/01/1989 (Seventeenth of January in the year One Thousand Nine Hundred and Eighty Nine)
at kuchaman city, Tehsil , District in the State of 'RAJASTHAN' within the territory of INDIA and he is a
CITIZEN OF INDIA and has domiciled in the State of Maharashtra.
PARTICULARS OF PROOFS SUBMITTED
1 . PAN Card
2 . Passport
3 . Electricity Bill
4 . Bonafide Certificate
5 . Residence Proof by Talathi
6 . Other
7 . SelfDeclaration
8 . RSBY Card
9 . Voter ID Card
10 .MNREGA Job Card
11 .Photo of Applicant
12 .Signature of Applicant
13 .Water Bill
14 .Property Tax Receipt
15 .Extracts of 7/12 and 8 A/ Rent Receipt
16 .Property Tax Receipt
17 .Property Registration Fee
Digitally Signed by
18 .Extracts of 7/12 and 8 A/ Rent Receipt Rupali Chandrakant Sonavane
Date:28-01-2020 5:08:33 PM
This is a digitally signed document, hence is legally valid as per the Information Technology (IT) Act, 2000.
To verify visit https://www.mahaonline.gov.in/Verify OR SMS “MH<space>CSC<space>VRFY<20 digit Barcode number>” to 166 from a BSNL, MTNL, Tata Mobile and
51969 from others.