Relationship Certificate: Government of Kerala

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FORM 4C

(See Rule 3)

GOVERNMENT OF KERALA
MUNDUR 1 VILLAGE OFFICE

RELATIONSHIP CERTIFICATE
No. 72872499 Date: 19/11/2022

Name of Person to whom certificate


SUNITH R
is issued
Gender Male
Address CHUNGATH HOUSE, 07/689, MUNDUR
Post Office with PIN Code MUNDUR, 678592
Name of Local body Mundur
Village Mundur1
Taluk Palakkad
District Palakkad

Certified that SUNANTHA, CHUNGATH HOUSE MUNDUR is related to the person(s) mentioned
below and the nature of relationship is as stated.

Name Relationship Age


SUNITH Son 33

Date of Issue of Certificate 19/11/2022


Designation of the issuing officer Village Officer
Purpose for which the certificate is issued
GENARAL
for
Remarks Nil
This certificate is issued based on the details given in the application, local enquiry, facts and
records produced.

Security Code : 10TU0

NOTE:

1. This digitally signed document is legally valid as per the Information Technology (IT) Act, 2000.
2. Authenticity of this document can be verified from http://edistrict.kerala.gov.in/ and submitting the Certificate Number and
Security code. Alternatively, please call thenumbers 155300(rfrom BSNL landline), 0471155300(from BSNL mobile),
04712335523/04712115094/04712115098(from other networks) and quote the Certificate Number to the operator.

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