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Questions Answers

1. What is your full name and address?

2. a When and where were you born?


b Where were you educated?

c Have you ever been to your former


Native place? If so, for how many times, and
for how long on each occasion?
When did you last visit it? If not, what
prevented you from going there?
d Are you married? If so, has your wife ever
been to your native place, and if yes, how
often and for how long on each occasion?

e How many children do you have? Where are they?


Are they being educated and what are they doing?

f For how many years have you and your family


been residing in the State of Maharashtra?
g Have you or your wife/husband any property
in the State of Maharashtra? if so, of what
description & value?

h Have you or your wife/husband any immovable


property in the State of Maharashtra? if so, of
what description & value?

3. a When and where was your Father / Husband born?


b What was / is his profession or occupation?
c Where was your father’s home or place or
permanent residence at the time of your birth?

d Where was your father when you attained maturity?


e Is he alive? If not, when and where did he die?

4. Was your Father / Husband ever in the State of


Maharashtra? If he was:-
a Where was he educated?

b For what purpose did he come to the State of


Maharashtra and work there?

c How often did he or has he left the State of


Maharashtra and for how long on each occasion?
d If your father/husband is alive, where is he and what
is he doing? Has he retired? If so, how long did he
remain in the State of Maharashtra after retirement?

e If your father/husband is dead, had he retired before


his death? If so, how long did he remain in the State
of Maharashtra after retirement?

f Has or had your father any immovable property


in the State of Maharashtra or elsewhere? If so,
where and of what description & value?

g Do they hold any passport? If so, give details.

5. Have you or had you any brothers and sisters?


If so, how many? Where were they or are being
educated? Where are they now and what are
they doing? If any of them are dead, where did
they die and what were their occupations?

6. Have you ever claimed and been deemed to


be a native of any place other than the State
of Maharashtra for the purpose of your
appointment to any office or for conferment
upon you of any scholarship, emoluments or
other privileges in that place?

7. a For what purpose did you require the Domicile


Certificate?

b Did you apply for a certificate of Domicile at any


time before and if so, when?

c Does your husband hold domicile and/or


citizenship certificate? If so, state particulars.

d Whether you hold passport? If so, give details.

Place:

Dated:
Signature of Applicant

N.B.
(1) If it is found that the replies given by the applicant to the question set above or to any of them
are incorrect, any admission obtained or benefit obtained thereby shall be summarily cancelled
(2) Applicant will be required to produce proof with regard to his or her birth place, birth date and
such other proof as may be necessary

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