FORMAT OF CERTIFICATE

ANNEXURE-VI: OBC
FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES APPLYING FOR APPOINTMENT TO
POSTS / ADMISSION TO CENTRAL EDUCATIONAL INSTITUTIONS, UNDER THE GOVERNMENT OF INDIA
This is to certify that Shri/Smt./Km. Son/Daughter of

Shri/
Smt of Village/Town
District/Division in the State/Union Territory belongs to the Community which is recognized as a backward class under:

Resolution No. 12011/68/93-BCCI dated 10/09/93 published in the Gazette of India Extraordinary Part I Section I No.
186dated 13/09/93.
Resolution No. 12011/9/94-BCC dated 19/10/94 published in the Gazette of India Extraordinary Part I Section I No.
163dated 20/10/94.
(i ii) Resolution No. 12011/7/95-BCC dated 24/05/95 published in the Gazette of India Extraordinary Part I Section I No.
88 dated25/05/95.
(iv) Resolution No. 12011/96/94-BCC dated 9/03/96.
(v) Resolution No. 12011/44/96-BCC dated 6/12/96 published in the Gazette of India Extraordinary Part I Section I No.
21 Odated 11/12/96.
(vi) Resolution No. 12011/13/97-BCC dated 03/12/97.
(vii) Resolution No. 12011/99/94-BCC dated 11/12/97.
(viii) Resolution No. 12011/68/98-BCC dated 27/10/99.
(ix) Resolution No. 12011/88/98-BCC dated 6/12/99 published in the Gazette of India Extraordinary Part I Section I No.
270dated 06/12/99.
(x) Resolution No. 12011/36/99-BCC dated 04/04/2000 published in the Gazette of India Extraordinary Part I Section I
No. 71 dated 04/04/2000.
(xi) Resolution No. 12011/44/99-BCC dated 21/09/2000 published in the Gazette of India Extraordinary Part I Section I
No.
21 Odated 21/09/2000.
(xii) Resolution No. 12015/9/2000-BCC dated 06/09/2001.
(xiii) Resolution No. 12011/1/2001 -BCC dated 19/06/2003.
(xiv) Resolution No. 12011/4/2002-BCC dated 13/01/2004.
(xv) Resolution No. 12011/9/2004-BCC dated 16/01/2006 published in the Gazette of India Extraordinary Part I Section I
No. 21 Odated 16/01/2006.
(xvi) Resolution No. 12011/14/2004-BCC dated 12/03/2007 published in the Gazette of India Extraordinary Part I Section I
No. 67dated 12/03/2007.
(xvii) Resolution No. 12015/2/2007-BCC dated 18/08/2010.
(xviii) Resolution No. 12015/13/2010-BCC dated 08/12/2011.

Shri/Smt./Km. and/or his/her family ordinarily reside(s) in

the District/Division of the State/Union

Territory. This is also to certify that he/she does not belong to the persons/sections (Creamy Layer) mentioned in Column 3
of the Schedule to the Government of India, Department of Personnel & Training O.M. No. 36012/22/93-Estt.(SCT) dated
08/09/93 which is modified vide 0M No. 36033/3/2004 Estt.(Res.) dated 09/03/2004, further modified vide 0M
 FORMAT OF CERTIFICATE
No.36033/3/2004-Estt.(Res.)dated 14/10/2008, again further modified vide 0M No.36036/2/2013-Estt (Res) dated
30/5/2014 or the latest notification of the Government of India.
Dated:

District Magistrate / Deputy Commissioner

/ Any other Competent Authority
Seal :
NOTE:
(a) The term 'Ordinarily resides' used here will have the same meaning as in Section 20 of the Representation of the People Act,
1950.
(b) The authorities competent to issue Caste Certificates are indicated below:
District Magistrate / Additional Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector /
1st Class Stipendiary Magistrate / Sub-Divisional magistrate / Taluka Magistrate / Executive Magistrate / Extra Assistant
Commissioner (not below the rank of 1st Class Stipendiary Magistrate).
Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.
1. Revenue Officer not below the rank of Tehsildar' and
2. Sub-Divisional Officer of the area where the candidate and / or his family resides.

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ANNEXURE- V": SC/ST

1. This is to certify that

Shri/Smt.*/Kumari*Son/daughter* of Of village/town* in
District/Division* of the State/Union Territory* Belong to the . Caste/Tribe* which
is recognized as a Scheduled
Caste/Scheduled Tribe* under:
*The Constitution (Scheduled Castes) Order, 1950
*The Constitution (Scheduled Tribes) Order, 1950
*The Constitution (Scheduled Castes) (Union Territories) Order, 1951
*The Constitution (Scheduled Tribes) (Union Territories) Order, 1951
{As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification Order) 1956, the Bombay Reorganization Act,
1960, the Punjab Reorganization Act 1966, the State of Himachal Pradesh Act, 1970, the North-Eastern Areas (Reorganisation)
Act, 1971 and the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976} *The Constitution (Jammu & Kashmir)
Scheduled Castes Order, 1956;
*The Constitution (Andaman & Nicobar Islands) Scheduled Tribes Order, 1959, as amended by the Scheduled Castes and
Scheduled Tribes Orders (Amendment) Act 1976;
*The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962;
*The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962;
*The Constitution (Pondicherry) Scheduled Castes Order, 1964;
*The Constitution (Uttar Pradesh) Scheduled Tribes Order, 1967;
*The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968;
*The Constitution (Nagaland) Scheduled Tribes Order, 1970
*The Constitution (Sikkim) Scheduled Castes Order, 1978
*The Constitution (Sikkim) Scheduled Tribes Order, 1978
*The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989
*The Constitution (Scheduled Castes) Orders (Amendment) Act, 1990
*The Constitution (Scheduled Tribes) Order Amendment Act, 1991
*The Constitution (Scheduled Tribes) Order Second Amendment Act, 1991
2. This certificate is issued on the basis of the Scheduled Castes/Scheduled Tribes Certificate issued to Shri/Smt*
 FORMAT OF CERTIFICATE
.. father/mother* of Shri/Smt/Kumari . Of
Village/ town*. in District/Division*... of the State/Union Territory*
. who belongs to the . .Caste/Tribe* which is recognized as a Scheduled
Caste/Scheduled Tribe* in the State/Union Territory* issued by the
Dated
3. Shri/Smt*/Kumari* . and/or* his/her family ordinarily reside(s) in village/town*
. of...................................... District/Division* of the State/Union Territory of
Signature
Designation.
(With seal of Office)
Place : State

Date Union
Territory
NOTE: The term "Ordinarily resides" used here will have the same meaning as in Section 20 of the Representation of the
Peoples Act, 1950.
*Please delete the words which are not applicable.

AUTHORITIES EMPOWERED TO ISSUE SCHEDULED CASTE/SCHEDULED TRIBE CERTIFICATES

{C.I. Dept. of Per. & Trg. O.M. No. 3012//88-Estt. (SCT), (SRD Ill) dated 24.04.1990}
The under mentioned authorities have been empowered to issue Caste Certificates of verification:

1. District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/ Additional Deputy

Commissioner/Deputy Collector/First class Stipendiary Magistrate/Sub Divisional Magistrate/Taluka
Magistrate/Executive Magistrate/Extra Assistant Commissioner.
2. Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
3. Revenue Officer not below the rank of Tehsildar
4. Sub-Divisional Officer of the area where the candidate and/or his/her family normally resides

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ANNEXURE- VI": EWS
Government of India
(Name & Address of the authority issuing the certificate)

INCOME & ASSET CERTIFICATE TO pRopucep ECONOMICALLY WEAKER SECTIONS

Certificate No. Date

VALID FOR THE YEAR

1 . This is to certify that Shri/Smt./Kumari son / daughter / wife of
permanent resident of Village / Street
Post Office District in
the State / Union Territory Pin Code Whose photograph is attested
below belongs to Economically Weaker Sections, since the gross annual income* of his/ her 'family'** is
below Rs. 8 Lakh (Rupees Eight Lakh only) for the financial year His/ her family does not own or possess
any of the following assets **
1. 5 acres of agricultural land and above;
 FORMAT OF CERTIFICATE
Il. Residential flat of 1000 sq. ft. and above;
Ill Residential plot of 100 sq. yards and above in notified municipalities;
IV Residential plot of 200 sq. yards and above in areas other than the notified municipalities.
2. Shri/Smt./Kumari belongs to the caste which is
not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward Classes (Central List).

Signature with seal of Office Name

Recent Passport
size Designation

attested photograph
of the applicant

*Note 1: Income covered all sources i.e. salary, agriculture, business, profession etc.
** Note 2: The term "Family" for this purpose include the person, who seeks benefit of reservation, his/ her parents and
siblings below the age of 18 years as also his/her spouse and children below the age of 18 years.
***Note 3: The property held by a "Family" in different locations or different places/cities have been clubbed while
applying the land or property holding test to determine EWS status.

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