ANNEXURE "B"
FORM OF APPLICATION FOR THE ISSUE OF DIVERGENCE CERTIFICATE
Name :
Detailed Address :-
Father’s Name :-
Date and Place of Birth :-
His/Her Profession/Occupation :-
Whether married/unmarried :-
If Married, Wife’s/Husband’s Name :-
Name as per Birth Certificate, School Leaving Certificate etc., or other documents :-
Name as mentioned in any other documents or as the person is known :-
Documentary evidence relating to the Divergence Certificate required :-
Purpose for which the certificate is required:-
Signature of the applicant
This application should be supported by the following documents :-
Birth Certificate.
School Leaving Certificate.
Ration Card.
Affidavit.
Any other document relevant to the matter.