Proforma of Nationality  Certificate:

                                                   SL.NO.. . . .. . . . .                                                      

 DC(IE)/6/2/9
GOVERNMENT OF MANIPUR 
OFFICE OF THE DEPUTY COMMISSIONER
IMPHAL EAST DISTRICT
 

    NATIONALITY CERTIFICATE

 

                                             Porompat, the . . . ………………….

               This is to certify that Shri/Smt./Km  ................................................................................. . ………………………………………………………………………………………………………S/O,D/O,W/O,Shri/Smt . . . . . . . .. .  . .. .. .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .…………………………………………, Imphal East District is a Domicile of Manipur State and a Citizen of India by birth. 

                He /She is not related to me.

D.C/Dist. Magistrate/Addl. Dist. Magistrate 

Imphal East District, Manipur.