Meeseva CDMA Death Corrections Application Form

Download Meeseva CDMA Death Corrections Application Form.
The CDMA Death Corrections Application Form will be like below download the form and fill all the details and attach required documents:

CDMA Death

Death Details:-

District: __________________________

Registration Number: _______________

_________________

Location: Greater Municipality Municipality

Gender: Male Female

Corrections Required in Death Certificate

Whether You Want to Update Deceased

Changed Child Surname: ___________________

Whether You Want to Update Date of

Changed Date of Death: _________________________

Whether You Want to Update Gender:

Changed Gender: Male Female

Whether You Want to Update Deceased

Changed Father Surname: ____________________ C

Whether You Want to Update Deceased

Changed Mother Surname: ___________________ C

Whether You Want to Update Death Place:

Changed Death 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: ___________________

Purpose of the Certificate ___________________________________________________________________

No of copies: ________________

Death Corrections Application Form

__________________________ Registration Unit Id: _____________________________________

_______________ Registration Year: _____________ Death Year:

Municipality Municipal Corporation Gram Panchayat

Certificate Details:-

Deceased Name: Yes No

___________________ Changed Child Name: _____________________________

Death: Yes No

_________________________

Whether You Want to Update Gender: Yes No

Deceased Father Name: Yes No

____________________ Changed Father Name: ___________________________

Deceased Mother Name: Yes No

___________________ Changed Mother Name: ___________________________

Place: Yes No

___________________________

You Want to Update Address at the Time of Death: Yes No

Time of Death: _________________________________________________

he Time of Death: _________________________________________________

Permanent Address: Yes No

Address: ________________________________________________________

_________________________________________________________________________

w/o H/o M/o F/O C/o

: _____________________________________________________________

______________________________________________________________________

____________________ Email ID: ______________________________________________

______________________________________________________________________________

Delivery Type: Manual / In Person Post – Local

_________________________________________________

: _________________________________________________

Address: ________________________________________________________

_________________________________________________________________________

: ______________________________________________________________________

______________________________________________________________________________

Local Post - Nonlocal

___________________________________________________________________

Document List:-

1. Application Form*

2. Original Death Certificate issued by the Registrar of

3. In case of Medico Legal cases for death events, certificate from the concerned police authority is a

must along with FIR and postmortem report

4. Notary Affidavit on Rs.10/- Non

5. Available Documentary evidences like educational certifi

Passport, Driving License and Marriage certificates

6. A letter from the Hospital Authorities where the

Note: Please upload Application Form and any one of

Applicant’s Signature

Certificate issued by the Registrar of Death

In case of Medico Legal cases for death events, certificate from the concerned police authority is a

must along with FIR and postmortem report

Non-Judicial Stamped paper

Available Documentary evidences like educational certificates, Election ID Card, Ration Card,

Passport, Driving License and Marriage certificates

A letter from the Hospital Authorities where the Death has occurred

Note: Please upload Application Form and any one of Above Documents as a single file in pdf format

Pages

Meeseva CDMA Death Corrections Application Form

Meeseva CDMA Death Corrections Application Form