Late Registration Of Birth Application Form printable pdf download

Late Registration Of Birth Application Form

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Late Registration of Birth Application Form

The Revenue Divisional Officer,

___________________ Division,

___________________ District.

Respected Sir,

Sub: - Request for Issue of the Birth Certificate of my son/daughter-regarding.

I, ______________________S/O / D/O / F/O / M/O / W/O________________________,

Age ____ years, occupation: _________, R/o H.No. ______, Near______________,

____________ Mandal, ________________Dist. Andhra Pradesh submit the following few lines

for your kind perusal and sympathetic favorable consideration please.

That my wife’s name is ___________________ Age ________ years and my son/daughter

___________________was born on__________ (dd/mm/yyyy) in _______ Delivery at

H.No.________, Near________, ___________ Mandal/Municipality, _____________ Dist.

Andhra Pradesh. The information regarding birth of my son/daughter was not informed to the

local Births and Deaths Registration Authority of ____________Mandal/Municipality. Hence the

name of my son /daughter is not recorded in the Birth & Death Register of

______________________ Mandal/Municipality.

That my son/daughter requires birth certificate for further education urgently.

I enclosed here with Non availability certificate issued by the GP or Municipal

Commissioner, Ration card copy, SSC marks memo and Self Affidavit.

Therefore I request you kindly to issue necessary orders to Commissioner, Municipal

Council__________

to record date of birth of my son/daughter and issue Birth Certificate as

above at the earliest.

Contact Details:

Landline Number:

Yours faithfully,

Mobile No:

E-Mail ID:

Signature of the Applicant

Procedure: (following to be enclosed)

1) Physical

Document*

2) Non availability certificate issued by the GP or Municipal

Commissioner#

3) Ration card

copy#

4) SSC marks

memo#

5) Self

Affidavit#

*-mandatory

-any one of them

Late Registration Of Birth Application Form

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