Ahmet 18 DECLARATION BY THE CANDIDATE IN LIEU OF OBC-NCL CERTIFICATE Name of the candidate Gurwenrt kaue 6G Address: re ALA Bazar —Popagum, =HYDERABAD Application Number of CUBT 2024 Mobile No: 9346428800 Email gure ling.02 Grund com V understand that as per the new guideline from the Manisiry of Personnel. Pubbe Grievances and Pensions, Gol, | am required to substi! the OBC-NCL cemificate issued on or after 1 April 2022 Since I have not been able to collect the said certificate on ume, | may kindly be allowed to write CUET (UG) - 2023 provisionally. Unerehy declare that 1 ill upload a fresh certificate (issued on or after 1 April 2022) at the me of reporuny after seat allocation. T understand that inability to upload the same by the given dute and tume ‘will lead to the withdrawal of the OBC-NCI benefit. | also understand that, 1f qualified, my category Will be adjusted accordingly in the Common Rank List Signature of Father/Mother Name GONWANT kaAoR Git Date Signature of Applicant DateAnnexure-lA OBC-NCL Certificate Format El RD CLASSES SCP APEL YING ROE ADI BrouTod ae eh Se TIONAL Net TUTIONS INCL)* ING FOR ADMISSION RAL EDUCA “Se ‘cus, UNDER THE GOY ERNMENT OF INDIA Sonl mnu/Koms®: ky This ist certify that Shri/Smt/Kum** Quota : Fravines aughter** of Shri/Smt** —HaR a seni e en ay RARAD DistrieyDivision® “eae nceias Maal cet ae belongs to the Jnion Territory = ; ae the — inion Verity community that is recognized as a backward ois ee Government of India®**, Ministry of Social Justice and Empowerment’s Resolution No. dated. oes ae ly seside(s) in the; Es ee DistricvDivision of the his/her family ordinarily reside(s} se TELANGAMA_—_StaoUnion Temitory. This is also to certify that he/she does NOT belong to the persons/sections (Creamy Layer) mentioned in Column 3 of the Schedule to the Goverment 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 Est. (Res.) dated 09/03/2004, further modified vide OM No. 36033/3/2004-Bstt. (Res.) dated 14/10/2008, again further modified vide OM No.36036/2/2013-Estt (Res) dated. 30/05/2014, and again further modified vide OM No. 36033/1/2013-Estt (Res) dated. 13/09/2017. District Magistrate/Deputy Comesisionse Any other Competent Authori Dated: Seal 2 ue 7 OBCs. ** Please delete the word(s) which are wot applicable. *** As listed in the Annexure (for FORM-OBC-NCL) **** The authority issuing the certificate needs to mention the details of the Resolution of Government of India, in which the caste of the candidate is mentioned as OBC. NOTE: (a) The term ‘Ordinarily resides’ uscd here will have the same meaning as in Section 20 of the Representation of the People Act, 1950, ) The authorities competent to issue Caste Certificates are indicated below @ District Magistrate/ Additional Magistrate/ Collector! Depry Commissioner! Additional Deputy Commissioner/ Deputy Collector/ Ist Class Stipendiary Maxistrate/ ‘Sub-Divisional magistrate’ Taluka Magistrate! Executive Magistrate’ Extra Assistant Commissioner (not below the rank of Ist Class Stipendiary Magistrate. ® Chief Presidency Magistrate / Additional Chief Presidency Magistrate Presidency Magistrate, @ Revenue Officer not below therank of Tehsildar’ and P Sub-Divisional Officer of the area where the candidate and/or his family resides