(Death Certificate.)

							                                                         (Death Certificate.)



                                                                                                                             From :        …………………………………………………
                                                                                                                             R / o. H. No. …………………………………………………
                                                                                                                             Date :        …………………………………………………


 To,
 The Chief Officer,
 Daman Municipal Council,
 Daman.

                                    Sub : To issue me a Death Certificate.
 To Respected Sir,
 I, the undersigned applicant kindly request your good self to please issue me a Death Certificate in
 respect of my self / Son / Daughter / Father / Mother / Cousin / Nephew.


 The detail are as under :


 1. Name of Person / Child      :   ...............................................................................................................................


 2. Name of Father              :   ...............................................................................................................................


 3. Name of Mother              :   ...............................................................................................................................


 4. Sex                         :   ...............................................................................................................................


 5. Date of Death               :   ...............................................................................................................................


 6. Place of Death              :   ...............................................................................................................................


 7. Reg. No.                    :   ...............................................................................................................................



I am ready to pay Necessary fees for the same.

Thanking you,




Encl. : Receipt of House Tax.


                                                                                                                             .............................................................................

                                                                                                                                                  Your Faithfully,