sriD star STAMPOUTY aNonma prapesH prey Wow subreiat Rs. 50000010 2720 363894 3 36874 = NO23/2008 INDIA 002145060711 AnouRa rRapesn AFFIDAVIT |, SHAIK JAIBUN BEE, W/o. Late SHAIK KHAJA HUSSAIN, aged about_S5_ years, Indian- Islam-Muslim resident of H.No.46-496, Budhawaray Kumool, Kurnool_District, Andhra Pradesh, do hereby solemnly affirm and state as follows:- ! belong fo Indian-Islam-Muslim Community. My sub caste is SHAIK SL.No.12 which comes under Backward Classes 'E’ are observing Muslim customs and rites only. | was born on 09/07/1965, | am an illiterate person, I have no any documentary proofs in support of my Educational Qualifications and I put my signature in LT. 1am applying for Backward Classes ‘E’ Certificate and for the entry of the Caste of the said Candidate in concem records (Vide G.O.Ms.No.24 Dated: 12-07-2007) under Backward Classes *E' and for the issue of a certificate under the above category for which | am swearing this affidavit. My Family Annual Income is Rs.60, 000/- p.c. That the above stated facts are true and correct to the best of my knowledge and belief, if proved to be false | shall be liable for prosecution. That this affidavit is sworn as required by the concemed authorities for the above said proof for applying for Study purpose. Hence, | request you to kindly issue Caste Certificate to me in lieu of which | am swearing this affidavit. Solemnly affirmed and signed before me at Kurnool on 21+ of July, 2020. NOTARY ATTESTED Vv oneeyt + Gopal Ra0, stine2@, ADVOCATE & NOTARY ~ooointed by Govt, of A.P GO, Ne, 277 Nehru Negar, KURNOUL,