GOVERNMENT OF ODISHA

Office of the Tahasildar Balasore

Miscellaneous Certificate Case No: E-SEB/2022/465747
ANNEXURE-'C'
FORM OF CASTE CERTIFICATE FOR SOCIALLY AND EDUCATIONALLY BACKWARD CLASSES OF THE STATE

This is to certify that Shri SARBESWAR KHUNTIA son of Smt GITANJALI KHUNTIA and Shri
PRADIP KUMAR KHUNTIA of village Dumuria P.S. SADAR BALASORE , district BALESHWAR in
the State of Odisha belongs to the Khandayat community which is recognized as a Socially and
Educationally Backward Class under the Government of Odisha, Department of Tribal Welfare
Resolution No. 25455 Emp. (Vii)-M-23/93 dated : 10. 09. 1993 (TW) published in Odisha
Gazatte(Supplement) No.40 dated 1-10-93.

Shri SARBESWAR KHUNTIA and his family ordinarily reside(s) in the BALESHWAR District of the
State Odisha.

This is also to certify that he does not belongs to the persons/sections (Creamy layer) mentioned in
column 3 of the schedule appended to the office memorandum No.4030/ dated 29-1-1992, EMP
(VII)92-93.

dgSign2031LocnDyna
Signature of the Revenue Officer
27/12/2022

**** This is a Computer Generated Statement And Does Not Require Signature ****
NOTE
(i) It is a digitally signed electronically generated certificate and therefore needs no ink-signed signature.
(ii) This Certificate is issued as per section 4, 5,& 6 of Information Technology Act 2000 and its subsequent amendments in 2008
and as per Revenue & Disaster Management Department Notification number IMU-13/10-4251/R&DM.
(iii) For any Query or Verification , Agency /Department / Office may visit https://edistrict.odisha.gov.in
(iv) Tampering of this Certificate will attract penal action.

Reference No: E-SEB/2022/465747 To View: https://edistrict.odisha.gov.in/t/HQCZc/B68DC32B Token No: B68DC32B