FORM No.

III
(See Rule 3)
GOVERNMENT OF ODISHA
Office of the Tahasildar Talcher
Miscellaneous Certificate Case No E-INC/2024/155138
INCOME CERTIFICATE
(Valid for the Financial Year 2023-2024)

This is to certify that Shri JITENDRA MOHARANA son of Smt SABITRI MOHARANA and Shri MADAN MOHAN
MOHARANA, is a native/permanent resident of the district of ANUGUL in the state of Odisha and he or his family is
presently residing at Village/town TALCHER TOWN P.S TALCHER Tahasil Talcher in the district ANUGUL of in the
state of Odisha has an annual family income of Rs. 70000 (Rupees ) only from the sources specified below.
Sl Income(in
Source
No. Rs.)
Agriculture (including plantation, horticulture, dairying, poultry,
1 fisheries etc.)
2 Salary/ Wages/ Renumeration etc.
3 Trade/ Business/ Profession (Please Specify)
4 Other Sources(Please Specify)
Total 70000

dgSign2031LocnDyna
Signature of the Revenue
Officer
16/02/2024

**** This is a Digitally Signed Document 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-INC/2024/155138 To View: https://serviceonline.gov.in/t/XyUse/9422C799 Token No: 9422C799