revenue department , u.t. of dadra & nagar...

REVENUE DEPARTMENT, U.T. of Dadra & Nagar Haveli

APPLICATION FORM – MARRIAGE REGISTRATION CERTIFICATE

(UNDER <<THE HINDU MARRIAGE ACT, 1955>>)

APPLICANTDETAILS

1. UID (AADHAAR) No :

OR

2. Voter ID Card :

3. Name of Applicant (Bride or Groom) :

DETAILS OF GROOM ANDBRIDE

Groom Bride

4. Name*

:

5. Father’s Name*

: _

6. Mother’s Name*

: _

7. Date Of Birth*

: DD MM YYYY DD MM YYYY

8. Age (as on date of marriage) *

21 years 18 years

9. UID (Aadhaar No) :

10. Photo :

assport Size

Photograph

Size – 5 x 4.5

(Cm.) Or

2 x 1.75(Inch)

11. Address of residence after marriage:

House Name/No* :

Sub-Locality* :

Locality* :

Village/Town* :

Sub-division* :

District* :

State* :

Country* : ______________________________

PIN Code* :

12. Address of permanent residence before marriage:-

House Name/No* :

Sub-Locality* :

Locality* :

Village/Town* :

Sub-division* :

District* :

DD MM YYYY DD MM YYYY

Groom Color Passport Size

Photograph Size – 5 x 4.5

(Cm.) Or

2 x 1.75(Inch)

Bride Color Passport Size

Photograph Size – 5 x 4.5

(Cm.) Or

2 x 1.75(Inch)


State :

Country :

Pin Code :

13. Mobile No :

14. e-Mail : ________________@_________ ________________@_________

15. Marital status before marriage

(Attach Divorce decree/death

certificate of Husband/wife)

Unmarried Divorced Widower Unmarried Divorced Widower

16. Nationality (Attach proof of

____________________________ _____________________________

17. Religion :

DETAILS OF SOLEMNISATION OFMARRIAGE

18. Date of Solemnization of Marriage :

19. Whether Marriage was solemnized at Religious Place: Yes No

(Attach certificate from priest, Maulvi, Pandit, Gurudwara Prabandhak etc.)

20. The Religious custom practice under which marriage was solemnized:

21. Address of Place of Solemnization of Marriage in Delhi:

House Name/No:______________________ Sub Locality : ___Village/Town : ____________

Locality :______________________ District :____________________________

Subdivision :______________________ Country :____________________________

State :______________________

Pin Code :

DETAILS OFWITNESSES

Witness I Witness II

22. Name:

23. Father’s Name:

24. Mother’s Name:

25. Aadhaar No:

26. Address

House Name/ No

27. Identity Proof of Groom (Please tick one ,provide the document No .and attach the same)

Aadhaar Card PAN Card Ration Card With Photo Graph

Voter ID Card Pass Port Driving License

Any Govt. Recognized Document Document No

28. Identity Proof of Bride (Please tick one ,provide the document No .and attach the same)

DD MM YYYY





29. Date of Birth proof of Groom (Please tick one ,provide the document No .and attach the same)

Aadhaar Card (Verified DOB) Passport Driving License

Nursing home/Hospital Report SSC from recognized Birth Certificate

Board by Certificate from School signed by Principal on School Letter Head CMO/Doctor Report

Document No

30. Date of Birth proof of Bride (Please tick one ,provide the document No .and attach the same)

Aadhaar Card (Verified DOB) Passport Driving License

Nursing home/Hospital Report SSC from recognized Birth Certificate

Board by Certificate from School signed by Principal on School Letter Head CMO/Doctor Report

Document No

31. Address Proof of Groom After Marriage (Please tick one ,provide the document No .and attach the same)

Aadhaar Card Voter ID Card Driving License

PassPort Ration Card Electricity Bill DISCOM Name _____________

Water Bill Utility Name __________________ Gas Bill Company Name _________________

Telepone Bill Company Name __________________

Rent Agreement (Registered ) Bank Pass Boo Document No

32. Address Proof of Bride After Marriage (Please tick one ,provide the document No .and attach the same)


PassPort Ration Card Electricity Bill DISCOM Name ___________

Water Bill Utility Name __________________ Gas Bill Company Name _______________

Telepone Bill Company Name __________________

Rent Agreement (Registered ) Bank Pass Book Document No

33. Address Proof of Groom Before Marriage (Please tick one ,provide the document No .and attach the same)


PassPort Ration Card Electricity Bill DISCOM Name _________

Water Bill Utility Name __________________ Gas Bill Company Name _____________

Telepone Bill Company Name _____________


34. Address Proof of Bride Before Marriage (Please tick one ,provide the document No .and attach the same)



Water Bill Utility Name __________________ Gas Bill Company Name _________________

Telepone Bill Company Name ____________________

Rent Agreement (Registered ) Bank Pass Book Document No

35. Identity Proof of Witness I (Please tick one ,provide the document No .and attach the same)




36. Identity Proof of Witness II (Please tick one ,provide the document No .and attach the same)




37. Permanent Address Proof of Witness I (Please tick one ,provide the document No .and attach the same)



Water Bill Utility Name __________________ Gas Bill Company Name ______

Telepone Bill Company Name __________________ Any Other Govt. issued Document


38. Permanent Address Proof of Witness II (Please tick one ,provide the document No .and attach the same)

revenue department , u.t. of dadra & nagar...

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