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Certificate No. :: 717/2023

Mamlatdar Office, Surat City, Adajan
Area
Surat
Date :: 04/01/2023

Government of Gujarat
Form of the Certificate to be produced by the Other Backward Class Candidates Applying for
Appointment to Posts under The Government of India

This is to certify that, Shree VYOM DINESHKUMAR MODH Son of

DINESHKUMAR of village Adajan
Tahsil :: Adajan ::
District :: Surat of the Gujarat State belongs
to the Modh Ghanchi

Community, which is recognised as a Other Backward Class under the Government of India,

Ministry of Social justict and Empowerment's Resolution No. 12011/68/93-BCC(c) Dt 10/09/1993,1

2011/68/98-BCC dt 27/10/1999,12011/36/99-BCC dt 04/04/2000 Dated 04/04/2000

VYOM DINESHKUMAR MODH and his family ordinarily Resides in the

Surat District of the Gujarat State.

This is also to Certify that he/she does not belong to the Persons/Sections (Creamy Layer) mentioned in
Column No. 3 of the Schedule of the Government of India, Department of Personnel & Training O.M. No.
36012/22/93-Estt. (SCT) Dated 08/09/93 which is modified vide OM No. 36033/3/2004 Estt.(Res.) dated
09/03/2004 or the latest notification of the Govenment of India.
This Certificate is issued on the basis of following proofs ::

1 True Copy of School Leaving Certificate 2 Income Certificate

3 Ration Card 4 Affidavit attached with the application.
5 Any Government Document having citizen
photo

Mamlatdar
Office Seal Mamlatdar Office, Surat City, Adajan Area

Courtesy :: National Informatics Centre, Gujarat Digital Gujarat