Government of the Peoples Republic of Bangladesh

Office of the Chairman

..union parishad
P/S., Dist, Bangladesh

Ref: Date:
Family Certificate
This is to certify that the family of the . .Consists of the following
members:

SL NO NAME RELATION DATE PRESENT PERMANENT

OF ADDRESS ADDRESS
BIRTH

01 FATHER

02 .. MOTHER

03 SON/DAUGHTER . .

04 .. SON/DAUGHTER

They are Bangladeshi by birth and well known to me.

I wish them bright and happy future.

Sign & Name of the Chairman