FORM OF CASTE CERTIFICATE FOR SCHEDULE CLASS

Documents Verified:1. eaving/Bonafide Certificate issued by the Head Master/Principal of

_________
2. Affidavit Dated:___________
3. Xerox copy of Ration Card No _____________
4. Caste Certificate of ____No.____ Dated:______ Issued by ____________
5. Other
Certificate
/s:
____________________Application
of
Shri.
______________________ Dated:_________
6. School L
7. Other Affidavit/s :
8. Other Documents/s _________
This is to certify that Mr .________________Son/Daughter of Mr. ____________________
of Village __________,Taluka __________, District MUMBAI SUBURBAN of the State of
Maharashtra belongs to the __________Caste at Sr. No. ____ which is recognized as
a SCHEDULE CLASS under :
The Constitution (Scheduled Castes) Order, 1950.
The Constitution (Scheduled Castes) (Union Territories) Order, 1951.
As amended by the Scheduled Castes and scheduled Tribes Lists (Modification) Order, 1956 the
Bombay Reorganisation Act 1960, the Punjab Reorganisation Act 1966, the State of Himachal
Pradesh ActPunjab Reorganisation Act ,1976 the North Eastern (Reorganisation) Act , 1971 and the
Scheduled Castes and scheduled Tribes Order (Amended Act 1976).
The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956.
The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962.
The Constitution (Pondicherry) Scheduled Castes Order, 1964.
The Constitution (Goa,Daman and Diu) Scheduled Castes Order, 1968.
The Constitution (Sikkim) Scheduled Castes Order, 1978.

Shri. _____________and his/her family ordinarily resides in Village ______, Taluka

_____, District MUMBAI SUBURBAN of the State of Maharashtra.
CSC Location: _______
CSC ID: ____________
Txn.No: ____________
Date: ______________
Collectorate
Deputy Collector
MUMBAI SUBURBAN DISTRICT
SUBURBAN DISTRICT

MUMBAI

Note: - The term Ordinarily reside(s) used here will have the same meaning as in Section 20 of the
Representation of the Peoples Act. 1950
If it is later on found that the applicant has furnished incorrect or false information, this Certificate is
liable for cancellation.