To
The Mandal Revenue Officer
	Sub: 	Application for issue of Residential Certificate 			Requested Regarding
Respected Sir,
I, ..........................................S/o,W/o,D/o.............................R/o, House No. ...........................
beg to state the following few lines for your kind consideration and favourable orders. Herewith enclosing certificate copies of Residential Certificate of myself
I am residing in the above address which is in the Jurisdiction of  Mandal. On the strength of copies and my study certificates submitted to you for verification, I may kindly be issued Residential Certificate. On receipt of the certificates from Mandal officer. I will submit the same in ............................................................ for the purpose of ......................
I, therefore humbly request you to issue me the Residential Certificate.
Thanking you,
                							                   Yours faithfully
Date:          /       /   199			
Place: Hyderabad AP				   		                           (	  	              )
		(Applicant's Signature)
Encl : 	T.C./ Bonafide certificate xerox 
	Ration Card xerox

Residential Certificate
This is to certify that Smt/Kum./Sri .....................S/o, W/o, D/o ...................R/o, H.No....................is  residing in the above Address since ............. years.   I know him / her well to the best of my knowledge. Hence this certificate is issued under GO Ms No. 554 dated 2-8-1989 Revenue (A) Dept., and GO Ms No. 178 dated 6.8.1988, Social Welfare (J2) Dept. GO Ms No. 288 dated 28.11.1988, Social Welfare Department
Signature of Gazetted Officer
Official Seal:
Designation:
Name:
Date:
GOVERNMENT OF ANDHRA PRADESH
(REVENUE DEPARTMENT)
					Office of the 
					Mandal Revenue Officer

No. D /            /               /199		Dated:       /          / 1998

CERTIFICATE OF RESIDENCE
On the strength of the certificate issued by the following officer:
1.
2.
This is to certify that Mr. Kum,. Smt........................S/o, D/o, W/o ..........................
R/o ............................................ is residing at the above address since last (4) years. It is valid for employment / Education.
Place 	:
Date 	:				          Mandal Revenue Officer
					        ........................... Mandal