Meeseva CDMA Birth Corrections Application Form
Download Meeseva CDMA Birth Corrections Application Form.
The CDMA Birth Corrections Application Form will be like below download the form and fill all the details and attach required documents:
Birth Details:-
District: __________________________
Registration Number: _______________
Location: Greater Municipality Municipality
Gender: Male Female
Corrections Required in Birth Certificate
Whether You Want to Update Child Name:
Changed Child Surname: ___________________
Whether You Want to Update Date of
Changed Date of Birth: _________________________
Whether You Want to Update Gender:
Changed Gender: Male Female
Whether You Want to Update Father Name:
Changed Father Surname: ____________________ C
Whether You Want to Update Mother Name
Changed Mother Surname: ___________________ C
Whether You Want to Update Birth Place:
Changed Birth Place: ___________________________
Whether You Want to Update Address a
Changed Line 1 of Address at the Time
Changed Line 2 of Address at the Time
Changed Line 3 of Address at the Time
Whether You Want to Update Permanent
Changed Line 1 of Permanent Address: ________________________________________________________
Changed Line 2 of Permanent Address:
Changed Line 3 of Permanent Address: ________________________________________________________
Informant Details:-
Informant Name: _____________________________________________________________________
Informant Relation: S/o D/o w/o
Informant Address1: ______________________________________________________________________
Informant Address2: ______________________________________________________________________
Informant Address3: ______________________________________________________________________
Mobile Number: ____________________
Remarks: _______________________________________________________________
Pin code: ___________________ Delivery
Purpose of the Certificate ___________________________________________________________________
No of copies: ________________
CDMA Birth Corrections Application Form
__________________________ Registration Unit Id: _____________________________________
_______________ Registration Year: _____________ Birth Year: _________________
Municipality Municipal Corporation Gram Panchayat
Certificate Details:-
You Want to Update Child Name: Yes No
___________________ Changed Child Name: _____________________________
Birth: Yes No
_________________________
Whether You Want to Update Gender: Yes No
Whether You Want to Update Father Name: Yes No
____________________ Changed Father Name: ___________________________
Whether You Want to Update Mother Name: Yes No
___________________ Changed Mother Name: ___________________________
Whether You Want to Update Birth Place: Yes No
___________________________
her You Want to Update Address at the Time of Birth: Yes No
Time of Birth: _________________________________________________
Time of Birth: _________________________________________________
he Time of Birth: _________________________________________________
Permanent Address: Yes No
Address: ________________________________________________________
Address: ________________________________________________________
Address: ________________________________________________________
_____________________________________________________________________
w/o H/o M/o F/O C/o
: ______________________________________________________________________
: ______________________________________________________________________
______________________________________________________________________
____________________ Email ID: ______________________________________________
_______________________________________________________________________________
Delivery Type: Manual / In Person Post – Local Post
___________________________________________________________________
_____________________________________
___________________________
Birth: _________________________________________________
Birth: _________________________________________________
rth: _________________________________________________
Address: ________________________________________________________
________________________________________________________
Address: ________________________________________________________
_________________________________________________________________________
: ______________________________________________________________________
: ______________________________________________________________________
______________________________________________________________________
Post - Nonlocal
___________________________________________________________________
Document List:-
1. Application Form*
2. Original Birth Certificate issued by the Registrar of Birth
3. Declaration by Parent(s) attested by two gazetted officers
4. Notary Affidavit on Rs.10/- Non
5. Available Documentary evidences like educational certificates, Election ID Card, Ration Card,
Passport, Driving License and Marriage certificates
6. A letter from the Hospital Authorities where the Birtt has occured.
Note: Please upload Application Form and any one of Above Documents as a single file in pdf format
Applicant’s Signature