How to write the format of issuing an uninsured certificate?

* * * (Urban County) Public Security Bureau:

I am a comrade * * *, (male or female), with ID card * * * and current household registration address (detailed address information of current household registration book). This comrade did not participate in social insurance (pension insurance, medical insurance, unemployment insurance, work injury) in my household registration from * * to * * *.

Hereby certify that

Note: Different regions may need different formats. However, as a proof that you are not insured, you need to use an electronic format and the official seal of the Social Security Bureau. You'd better write the date you need from the above to * * month * * day * * year. If it is a necessary household registration transfer, it is only necessary to prove that the old-age insurance is not insured.