‘Appendix= I FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD CLASSES APPLYING FOR ADMISSION TO CENTRAL EDUCATIONAL INSTITUTES This bs to cotty that Shr/Smu/Kum. Soo/Danghar of Sheet. of Vilage Tow DinviedDivson te ‘ie Belong the ia ‘Community which recognized sa backward lin acer (© Remhaon No, 12011693-B00(0) dated 10593 published inthe Gant of India Extrucriony Part Scion {Nes 186 dated 130993. (i) Reolton No. 1201T//94-BCC de 19/1094 published inthe Gaze of India Extrwdinry Pat Seal I No 163 ted 2071094 Gi), Revolton No. 1201177950 dated 2409 plist in the Gaze of tna Extroordinry Pat 1 Seaion I No. 6 dated 25057. (Ge) Renalton No, 1201179694-BCC died 903096. (0) Renton No. 1201144486800 dated 6/1296 published inte Gant of India Extrodinry Pat | ‘Seaton Io. 210 dated 11/1296. (oi) Reston No, 12011/1397-BCC dated 03/1297. (i) Reston No. 120119994-BCC dated 11/1297 (il) Resolution No. 12011'6898-BCC dated 27/1099. (i) Resolution No. 12011/8898-BCC dated 0/1299 pubtised in te Gazene of Ina xan Pat ‘Seaton I No. 270 dated 06/1299. (0) Reaahaton No. 12011/3699-BOC deed 40012000 published in the Gazette of Ina Extaordinry Part | Sean I No.7! dated OUO42000. (x) Renolton No, I2011MA99-BCC dated 214872000 putised in the Cazene of tna Bxmaoriiony (it) Resolaon No. 12011//2001-BC date 1916/2008. {al} Relation No. 120114/2002-BCC dated 1301/2004. (er) Revoltion No. 12011/72008-BCC dated 1601/2006 published in the Gaze of Ina xeorinay Pant Soedon No. 210 dated 1601/2006 Stw/Su/Kum. anor his family ondiarty rests) inthe ‘State. This i abo ce Date: (0) The auhoriice competent o ase Caste Certifies ae indicated below: » (i) Chief Presidency Magistrate ! Additional Chief Presidency Magiate / Presidency Magistrate ip “Reveme Ofer not below the rank of Telia’ ec (is) Seb-Divisonl Officer ofthe wea wher the candle anc or his amily residesAppendix — 111 Declaration/Undertaking for OBC (Non-Creamy Layer) Candidates only sonidaughter of shi resident of vilagantowndeity istrict State hereby declare that | belong to the. ‘community which is recognized 25 Inackward class by the Government of India as per orders contained in tho Department of Personnel & Training Office Memorandum No, 26012/22/93-Est. (SCT) datod 08/09/1999, 1 steo declare that | do not belong to the persona/eections (Creamy Layer) mentioned in Column 3 of the Schedule to the above referred Office Memorandum, dated 08/00/1883, which Is modified vide Office Memorandum No. 36033/32004 Estt(Res.) dated 08/03/2004. Name of the Candie ‘Signature ofthe Candidate