The land of the Dancing Deer

 

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To
         The Deputy Commissioner, Bishnupur


       Subject:- Prayer for Domicile/Resident/Caste/Tribe Certificate.

Sir/Madam,

   I, the undersigned have the honour to request that you will kindly issue me Domicile/Resident/Caste/Tribe Certificate 
 for ……………………………….

  The following are my particulars :


1. Name (In block letter) :

2. Father’s Name :

3. Permanent Address :

4. P.O & P.S :

5. Electoral Roll Sl. No. and House No. :

6. Polling Station No. and Page No. :

7. Present Address :

                   For the matter of which I shall ever remain grateful and thankful to you.


Dated :- 
                                                                                         SIGNATURE OF THE APPLICANT
Place:-