Ene)
PSs ee
‘A Candidate who claims to belong to one ofthe scheduled caste or scheduled toe should submit in support of his/her claim a self attested copy of a
cetifcae in the form given below from the district magistrate or the sub-divsiona officer or any other ofcer as indicated below ofthe district in which
his/her parents (or surviving parents) ordinarily reside and who has been designated bythe State Government concerned as competent o issue such @
cetifcae.Ibotn the parents are dead, the officer signing the cerfcate should be ofthe distctin which the candidate himself /herselfresdes otherwise
than forthe purpose of his! her own education, Wherever, photograph isan integral part ofthe cetficate, the RRB would accept oly self attested
Photocopies ofsuch certificates and not any other attested or true copy.
{The Form ofthe certificate to be produced by Scheduled Castes and
‘Scheduled Tribes candidates applying for appointment to posts under the Government of India)
This is to cert that Shri! Shrimat / Kumari
sonidaughter of of Village / Town’. in District
Division’ of State! Union Tertory’.
belongs tothe. ssn Caste /Thbet which is recognised as a Scheduled Caste / Scheduled Trbe* under
The Constitution (Scheduled Castes) Order, 1950"
The Constitution (Scheduled Tribes) Order, 1950"
The Constitution (Scheduled Castes) (Union Territories) Order, 1951”
The Constitution (Scheduled Tribes) (Union Tetris) Order, 1951"
(As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) Order, 1956, the Bombay Re-organisation Act, 1960, the Punjab
Re-organisation Ac, 1966, the State of Himachal Pradosh Act, 1970 and the North Eastorn Area (Re-organisation} Act, 1971 and the Scheduled
Castes and Scheduled Tribes Orders, (Amendment) Act, 1976)
‘The Consttution (Jammu & Kashmir) Scheduled Castes order, 1956 @
‘The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 @ as amended by the Scheduled Castes and Scheduled Trbes
Order (Amendment) Act, 1976 @
The Constitution (Dadra and Nagar Havel) Scheduled Castes Order, 1962 @
The Constitution (Dadra and Nagar Havel) Scheduled Tribes, Order, 1962 @
The Constitution (Pondichery) Scheduled Castes Orders, 1964 @
The Constitution (Scheduled Tribes) (Uttar Pradesh) Order, 1967 @
The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968 @
‘The Consttution (Goa, Daman and Diu) Scheduled Tribes Order, 1968 @
‘The Consttution (Nagaland) Scheduled Trbes Order, 1970 @
The Consttulion (Sikkim) Scheduled Castes Order, 1978 @
The Constitution (Sikkim) Scheduled Tbes Order, 1978 @
Shi'ShrimatiKumari* and or his/her family, reside() in vilage /
town’, of DisticlDivsion" ofthe State / Union Teritory*
of
Signature,
“Designation,
(with seal of Office) StatelUnion Tertory**
Place.
Date.
* Please delete the words which arenot applicable.
@Please quote the specific presidential order.
Note: The term ordinary reide(s) used here willhave the same meaning asin Section 20 ofthe Representation ofthe Peoples Act, 1950.
* Officers competenttoissue CasteTribe certificates
* District Magistrate / Additonal District Magistrate / Collector / Deputy Commissioner Adltional Deputy Commissioner / Deputy Collector / 1st Cass
Stipendiary Magistrate City Magistrate Sub-Divsional Mag'strate / Taluka Magistrate / Executive Magistrate Extra Assistant Commissioner (notbelow
the rank of 1st class Stipendiary Magistrat) Chief Presidency Magistrate / Additional Chiof Presidency Magistrate / Presidency Magistrate / Revenue
Ofcersnot below the rank of Tahsilar/Sub-Divisional Ofcer ofthe area where tne cancdate and or his/her family normally resides),
Note ST Candidates belonging to Tamilnadu State should submit caste certficate ONLY from the REVENUE DIVISIONAL OFFICER.