eservices.goa.gov.in : Apply Online For Divergence Certificate

Name of the Organisation : e-Services Government of Goa
Type of Facility : Apply Online Divergence Certificate
Home Page : http://www.eservices.goa.gov.in/

Online Application for obtaining Divergence Certificate :
** This Application Is Addressed To Mamlatdar of concerned Taluka.
** The Fields marked with * are compulsory.
** Incase relevant documents are not uploaded,the application will be subjected to cancellation.
** The Reference No. generated after submitting the application online should be maintained for tracking the status of the application.

Apply Online

Applicant Details :
1. Enter Applicant’s Name
2. Enter Mobile No
3. Enter Email Id
4. Enter Id Proof
5. Enter the Id Proof Number

Personal Details :
1. Enter Applicant’s Name
2. Enter Diversion Name (As per Birth Certificate)
3. Enter Diversion Name (As per Other Documents)
4. Enter Father’s Name
5. Enter House No
6. Enter Ward/Road/Locality
7. Enter Taluka
8. Enter Village
9. Enter Pin code
10. Enter Birth Date
11. Enter Place of Birth
12. Enter Marital Status
13. Enter Profession/Occupation
14. Enter Purpose
15. Enter Remarks

Note:
1. If it is found that the applicant questions set above are incorrect by benefit derived hereby be summarily cancelled.
2. Application will be required to produce proof with regard date and place of Birth and such proof as may.

Following documents should be uploaded :
(1)Produce documentary evidence wherein the divergence of names have occured.
(2)Birth Certificate.
(3)An affidavit in the prescribed form given above.