RESIDENT REGISTRATION

This is to certify that this registration has the same contents as the original resident registration.

Date : . ,

Head Official at

Family Head :

Date of Organization of Family

Address

1. ooo City has been installed on ooo. oo, oooo

Name Resident Registration No.

1. Self :

2. Wife :

3. Son :

4. Daughter :

/S/ Official Seal Affixed

Head official

Oooo

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