FORM OF CASTE CERTIFICATE Form of Certificate to be produced by a candidate belonging to a Scheduled Caste/Tribe In support of his claim Proof 1) School leaving Certificate of Applicant issued by Head Master of vide R. No, ot 2) Caste Certicate of Fathor issued by Exe. Mag, Sakti NO 612 Dt. 6/06/1994 2) Residence Certificate issued by V.O ot 4) Afidavit executed by applicant Bofore ex Magistrate / Dated 14/01/2010 )Ration Card No, 0338603 ati Seated 65)0ther Doueuments Self Birth Cor. issued byBhivan 1 Corpo. 08.17102/2009 7) Fathers S.L.C. of New Eng, School, Dighave No.1268 Dt. 08/12/1988 y Gert leu by Scrutiny | Committee Nashik No.5587 D&8/08/2003 : | ‘This isto crt that BHOYE TANAVI PARSHARA an SonDaughter of * BHOYE PARSHARAM ZIPA ae: of Village/Town * of Taluka Kalyan in DistricyDivision, Than ofthe Maharashtra State eee tee seas ey belongs to the KOKNI (ST-25) “CasterTribe * which isrecognised as Scheduled Caste/Scheduled Tribe * under “The Constitution (Seheduled Castes) Order , 1950 ‘ ‘v’ The Constitution (Sehedulad Tribes) Order, 1950 Saas + The Constitution (Scheduled Castes) Union Territories Order 195 = + The Constitlion (Scheduled Tribes) (Union Tervtories Order), 1951-a[(As amended by the SchesUled Castes and ‘Scheduled Tribes Lists (Modification)Order 1956 the Bombay Reorg! pcan 1960. The Reorganisation Ai, 4968, the State of Himachal Pradesh Act 1976 the Nort Eastern Areas (Reorganisation) Act,1971 tind te Sonedutdd Gapleulnd Scheduled Ties Orders ‘trends 35 sie +The Consutton (Jamin a Kashi Schedles Caste 1958. He. The Gonattutn (Andanin and Nicober islands) Scheduled Tribes Order ,1950.a8 amended! by the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976, il “The Consitution (Oadra and Nagar Havel) Scheduled Castes Order, 1962 * The Constitution (Dadra and Nagar Havel) Scheduled Trives 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, 1988. “The Constitution (Goa , Daman and Diu) Scheduled Tribes Order, 1968. + The Constitution (Nagaland) Scheduled Tribes Order, 1970. + The Constitution (Sikkim) Scheduled Castes Order.1978, “The Constitution (Sikkim) Scheduled Tribes Order,1978. 2 BHOYE TANAVI PARSHARAM and /or his her family ordinarily Reside (s) in of Taluka Kalyan Thane District / Division of the State of Maharashtra, SRNO 1820/8T/2010 Soran Ho 00101542 210 Pct Thai cotecronatS JAN 20167 COLLECTOR OFFICE, THANE KALYAN TAHSIL SETU KENDRA Cerificate Prepared Date :- 12/01/2010