Scribd
Upload
3K views

Aadhaar Address Change-2

This document is a certificate for Aadhaar enrolment or update. It contains fields for the resident's details such as name, address, date of birth and photograph. It also contains details for the certifier such as their name, designation, office address and contact number. The certifier must sign and stamp the resident's photograph to certify the resident's identity details before the form can be submitted for Aadhaar enrolment or update.

Uploaded by

mchakravarthi28
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
3K views

Aadhaar Address Change-2

This document is a certificate for Aadhaar enrolment or update. It contains fields for the resident's details such as name, address, date of birth and photograph. It also contains details for the certifier such as their name, designation, office address and contact number. The certifier must sign and stamp the resident's photograph to certify the resident's identity details before the form can be submitted for Aadhaar enrolment or update.

Uploaded by

mchakravarthi28
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE

Instructions: All details to be filled in Block Letters  (To be valid for 3 months from date of issue)

To be printed on plain A4 paper size; Not required to print on letter head; D D M M Y Y Y Y


Resident’s Details
Resident Non-Resident Indian (NRI) New Enrolment Update Request

Aadhaar Number:
(For update only)

Full Name:

C/o:

House No./ Bldg./ Apt:

Street/ Road/ Lane:

Landmark:

Area/ Locality/ Sector:

Village/ Town/ City:

Post Office:

District:
Resident’s Recent
State: Colour Photograph
3.5cm x 4.5 cm

Cross Signed and


Cross Stamped
by the Certifier.

PIN Code: NB: DO NOT


OVERLAP WITH
TEXT BOXES
Signature of the Resident/
Date of Birth: Thumb/ Finger Impression

Certifier’s Details (To be filled by the certifier Only)


Name of the Certifier:

Designation:

Office Address:

Contact Number:

I hereby certify above mentioned details of the resident Checklist for Certifier
and I am a.... (Tick appropriate box below) No overwriting Issue date is filled Resident’s signature Certifier’s details
Gazetted Officer - Group A Resident’s Photo is cross signed and cross stamped (paper to photo or photo to paper)

Village Panchayat Head or Mukhiya


Gazetted Officer - Group B
MP/ MLA/ MLC/ Muncipal Councilor
Tehsildar
Head of Recognized Educational Institution
Superintendent/ Warden/ Matron/ Head of Institution
of Recognized shelter homes/ Orphanages
Signature & Stamp of the Certifier
EPFO Officer

NOTE: This format is applicable for POI documents at SI. Nos. 17, 20, 21, 22, 31 & 32; POA documents at SI. Nos. 23, 24, 37, 38, 44 & 45; POR documents at SI. Nos. 13
& 14 DOB documents at SI. Nos. 4, 5, 14 & 15 of Schedule II of the Aadhaar (Enrolment and Update) Regulations, 2016, as amended from time to time.

You might also like