CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE (TO BE USED ONLY AS PROOF OF ADDRESS*)

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 be printed 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

Certіfіer’s Details (To be fіlled by the certіfіer 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/ Municipal Councillor
Tehsildar
Head of Recognized Educational Institution
Superintendent/ Warden/ Matron/ Head of Institution
of Recognized shelter homes/ Orphanages
Signature & Stamp of the Certifier
EPFO Officer

*To be used as Proof of Identify (PoI) only in specific cases as mentioned in the list of applicable supporting documents.
 INSTRUCTIONS FOR FILLING UP Certificate for AADHAAR ENROLMENT/ UPDATE
(To be used only as proof of address*)

A. GENERAL INSTRUCTIONS ––– Please read these instructions carefully before filling the application form
The Application Form consists of two forms, i.e., Resident details and Certifier details.
Sample filled form is available at the end of these instructions. Residents are advised to view the sample filled form after reading these
instructions.
Incomplete or inappropriately-filled application form will not be accepted. Please follow the instructions given below while filling the form.
• Certificate has to be printed on Plain paper.
• Use CAPITAL LETTERS only, as shown in the image below –
r a m e s h R A M E S H

Incorrect Correct
• Use standard fonts and avoid stylized writing.
• Use black or blue ball point pen only. Do NOT fill the application form with ink-pen or pencil.
• Put a tick marks ( ), in the boxes where you have to select options as your answer and leave the other option(s) blank.
• Write clearly within the boxes without touching the boundaries. Try and write in the centre of the box, as shown in the image below–

Incorrect Correct
• Leave one box blank after each complete word, while filling up the boxes.
R A M E S H G U P T A R A M E S H G U P T A

Incorrect Correct
• Do NOT write “NA” or “N/A” or “NOT APPLICABLE” in any boxes in the form to convey that the column is not relevant for your case. Leave
that column blank.

B. FIELD -WISE GUIDELINES FOR FILLING UP “CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE”
”- Resident section

ensure all the fields are filled properly, as per below instructions.

S No Filed Name General Instructions

1 Date of Issue • Specify the date in DD-MM-YYYY format.
• Ensure Certificate is submitted within 3 months of date of issue.
• Enrollment or Update Request will be rejected if Date of Issue is blank or Certificate
has expired.
2 Resident Category • Specify the resident is native Resident of India or belongs to Non Resident Indian
(NRI) Category
3 Enrolment type • Specify the current request is either for obtaining a Aadhaar card which is known as
“New Enrolment” or for updating an existing Aadhaar details which is known as
“Update Request”.

4 Aadhaar Number • Mention your Aadhaar Number.

• In case of Enrolment, Kindly leave it blank.
• In case of Update, it is mandatory to specify the Aadhaar number.

5 Full Name • Mention the name of Resident.

• Name shall be mentioned in the format as to be recorded in the Aadhaar.

6 C/o • Mention the Care of (C/o) if required in the address field.

• This field can be left blank as well.

7 House No/ Bldg./ Apt: • Mention the House Number, Building Name or Apartment Name as per the address.

8 Street/Road/ Lane • Mention Street Name, Road & Lane of the address.

9 Landmark • Mention the Landmark near your address.

• This field can be left blank as well, if not required.
10 Area/ Locality/ Sector • Mention Area/ Locality/ Sector of your address.

11 Village/ Town/ City • Mention Village/ Town/ City of your address.

12 Post Office • Mention the nearest post office of your address.

• This filed can be left blank.

13 District • Mention the District of your address.

14 State • Mention the State of your address.
 15 Pin Code • Mention the pincode of your address.
16 Date of Birth • Mention the Date of Birth.

17 Signature • Resident shall do the Signature in the box specified for signature.
• Illiterate Resident can provide Thumb or Finger impression.

18 Resident Photo • Resident shall paste latest color photograph of size 3.5 cm X 4.5 cm.
• Ensure photo is pasted in the space provided. It shall not overlap in text boxes.
• Photo needs to be cross sign by the certifier.
• Photo needs to be cross stamped by the certifier.

C. FIELD -WISE GUIDELINES FOR FILLING UP “CERTIFICATE FOR AADHAAR ENROLMENT/ UPDATE”
”- Certifier section

Kindly ensure all the fields are filled properly by the Certifier, as per below instructions.

S No Filed Name General Instructions

1 Name of Certifier • Mention the name of Certifier

2 Designation and office • Specify the designation and office name of the Certifier.
name

3 Office Address • Specify the complete address of the certifier, along with Department name.

4 Contact Number • Specify the contact details of the certifier.

5 Certifier Type • Mention the certifier type by tick mark one of box from below categories:
o Gazetted Officer - Group A
o Village Panchayat Head or Mukhiya
o Gazetted Officer - Group B
o MP/ MLA/ MLC/ Municipal Councillor
o Tehsildar
o Head of Recognized Educational Institution
o Superintendent/ Warden/ Matron/ Head of Institution of Recognized
shelter homes/ Orphanages
o EPFO Officer
6 Checklist for Certifier • Verify the below checklist by tick mark the boxes:
o No overwriting
o Issue date is filled
o Resident’s signature
o Certifier’s details
o Resident’s Photo is cross signed and cross stamped (paper to photo or
photo to paper)
• Please ensure that complete form is duly filled, and all boxes of checklist all
selected.
7 Sign & Stamp of the • Provide certifier sign and stamp in the space specified.
certifier

D. IMPORTANT INSTRUCTIONS

Below are few important steps that resident shall ensure before submitting the form:

• This document can only be used as Proof of Address (PoA). For the specified cases defined in the list of acceptable supporting documents,
this certificate can also be considered as valid Proof of Identity (PoI).
• Certificate has to be printed on Plain paper.
• Form has to be submit with 3 months of date of issue.
• Kindly ensure No writing on the form.
• Date of issue has to be filled properly in DD-MM-YYYY format.
• Resident signature or thumb impression is must.
• Certifier details have to be properly filled in.
• Resident shall paste the latest colored photograph of 3.5cm X 4.5 cm with in the defined area.
• Certifier cross sign & cross stamp is must on the resident photograph.
• Certifier complete details must be filled in.

*To be used as Proof of Identify (PoI) only in specific cases as mentioned in the list of applicable supporting documents.

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