Application for Residence Certificate [md-form] [md-text label="Applicant Full Name"] [/md-text] [md-text label="Profession/Occupation"] [/md-text] [md-text label="Name of head of the household in which the applicant resides"] [/md-text] [md-text label="Place of Residence"] [/md-text] [md-text label="House No."] [/md-text] [md-textarea label="Wado/Street/Village etc"] [/md-textarea] [md-text label="Name of Village Panchayat"] [/md-text] [md-text label="The Period of residence or since when the applicant residing at the above referred place"] [/md-text] [md-text label="The place of residence prior in the place of resident as indicated above, in case the applicant was not staying continuously at the above given address"] [/md-text] [group group-971 clear_on_hide inline] [md-radio label="What you doing during last 6 months" display="inline"] UnemployedEmployedBusinessStudent [/md-radio] [group group-490 clear_on_hide] [md-text label="Where You Employed During Last 6 Months"] [/md-text] [/group] [group group-216 clear_on_hide] [md-text label="what type of business indulge during Last 6 Months"] [/md-text] [/group] [group group-691 clear_on_hide] [md-text label="Name of School/Organisation/institution"] [/md-text] [/group] [/group] [md-text label="Relationship of the applicant with the head of household with whom she/he resides:"] [/md-text] [md-text label="Whether the applicant’s name included In the ration card of this taluka and the Electoral roll in the affirmative indicate ration card no. and since when it is included:"] [/md-text] [md-textarea label="Whether the applicant has any Immovable Property or share in the place of residence And if so, give details"] [/md-textarea] [md-text label="Purpose for which the residence Certificate is required and before whom it is to be produced:"] [/md-text] [md-submit] [/md-submit] [/md-form]