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ANNEXURE – III(B)

Declaration

(For the candidate unable to submit the EWS Certificate at the time for Choice
Filling of CEE-2023)

Sahil Rahman
I, Shri/Smt. _______________________________________________________________
Khalilur Rahman
son/daughter of _________________________________________________________________
Faturi
an inhabitant of Vill./Town ___________________________ Dakshin Xoru Bongsha
Mouza ____________________

P.O.__________________
Faturi P.S. ________________________
Chaygaon Kamrup
District ______________________

Assam, hereby certify that I am a permanent resident of Assam and I have applied

for EWS Certificate. The application receipt of which is attached herewith. I shall

submit EWS Certificate at the time of Reporting & Document Verification. Failing to

do so will result in changing of my category from EWS to General for the entire

counselling Process.

Date: ______________
Signature: ______________________________
Name of the candidate: ____________________________

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