• This Application Is Addressed To Collectorate/District Magistrate.
  • 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.
  • Click Here to download Affidavit Format
  • Online Application for obtaining Domicile Certificate

    Applicant's Name*: Mobile No:
    Email Id: Id Proof:
    Enter the id Proof Number*:
    Personal Details
    Applicant's Title: *:
    Applicant's Name *:
    House No*: Ward/Road/Locality*:
    Taluka *: Village *:
    Pincode *:   
    Father's Title: *:
    Father's Name *:
    House No*: Ward/Road/Locality*:
    Taluka *: Village *:
    Pincode *:   
    Birth Date*: Pick a date (DD-MMM-YYYY)   Place of Birth*:
    Purpose *:
    Since when the applicant resides in Goa
    From date*: Pick a date (DD-MMM-YYYY)  
    Whether Domicile certificate is Obtained from any place other than Goa?
    Details
    Ration Card No.*:
    Remarks :
    Details of Immovable Property or Share in the Place of Residence
    Property Details *:
    Details of continuous residence in Goa for last 5 years.
    Residence Details *:
    Details whether he/she is owner/partner of Business/Firm.
    Details *:
    Application Applied to the  Office
    Taluka*:
    Enter the letter shown in the textbox below

         
     
  • 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.
  • 3. Following documents should be uploaded (1)Residence Certificate from Mamlatdar. (2)Birth Certificate.(3)Attested Copy of Ration Card.(4)An affidavit to the effect that domicile has been renounced in case where the applicant is born outside Goa (5)Application should be submitted with 2 passport size photographs