3 shrisrimatikumari and or hisher family ordinarily

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3. Shri/Srimati/Kumari* …………………..………………………… and /or* his/her* family ordinarily resides inVillage/Town* ................................................ District/ Division* ……………………………………. of the State/ Union Territory* of ............................................ Place .................................. Signature .................................................................. Date ................................... Designation ............................................................... (with seal of Office) State/ Union Territory ................................................ * Please delete the words which are not applicable. @ Please quote the specific presidential order. % Delete the Paragraph, which is not applicable Note: (a) The term “ordinarily reside(s)’ used here will have the same meaning as in Section 20 of the Representation of the People Act, 1950. Officers competent to issue Caste/Tribe certificates. 1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector / 1st Class Stipendiary Magistrate / Sub-Divisional Magistrate / Taluka Magistrate / Executive Magistrate / Extra Assistant Commissioner. 2. Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate. 3. Revenue Officers not below the rank of Tehsildar. 4. Sub-Divisional Officer of the area where the candidate and / or his / her family normally reside(s). 5. Certificates issued by Gazetteed Officers of the Central or of a State Government Countersigned by the District Magistrate concerned. 6. Administrator/ Secretary to Administrator (Laccadive, Minicoy and Admin div islands).
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Page 31 of 35 PROFORMA-VI GOVERNMENT OF ……………. (NAME & ADDRESS OF THE AUTHORITY ISSUING THE CERTIFICATE) INCOME & ASSEST CERTIFICATE TO BE PRODUCED BY ECONOMICALLY WEAKER SECTIONS Certificate No……………….. Date……..…………….. VALID FOR THE YEAR ……………………….. This is to certify that Shri/Smt./Kumari ……………………………. Son/daughter/wife of ……………………….. permanent resident of …………………… Village/Street ………………… Post Office …………………. District ……………….. in the State/Union Territory …………………… Pin Code ………………….. whose photograph is attested below belongs to Economically Weaker Sections, since the gross annual Income* of his/her ‘family*** is below Rs. 8 lakh (Rupees Eight Lakh only) for the financial year ……………….. His / her family does not own or possess any of the following assets***; I. 5 acres of agricultural land and above; II. Residential flat of 1000 sq. ft. and above; III. Residential plot of 100 sq. yards and above notified municipalities; IV. Residential plot of 200 sq. yards and above in areas other than the notified municipalities. 2. Shri/Smt./Kumari ……………………. belongs to the ………………… caste which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward Classes (Central List). Signature with seal of Office ……………………… Name …………………………….. Designation ………………………… *Note: Income covered all sources i.e. salary, agriculture, business, profession, etc. **Note 2: The term “Family” for this purpose include the person, who seeks benefit of reservation, his/her parents and siblings below the age of 18 years as also his/ her spouse and children below the age of 18 years.
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