IN THE COURT OF DY. COLLECTOR,NAGPUR (raotee) || Form Of Certificate to be produced by Other Backward Classes, Vimukt Jati(A) / Nomadic Tribe(B,C,D), and Special Backward Category and its synonyms belonging to State of | l Maharashtra alongwith Non Creamy Layer Status | | Documents Verified: 1. Application of Kumar SURAJ DEEPAK WANVE A | 2. Schoo! Leaving Certificate issued by Head Master of SHRI GAJANAN VIDYALAYA.NAGPUR. eg 3 | | 3. Affidavit before Executive Magistrate . | | 4, Ration Card |< 5.1) Application Form 2) Affidavit 3) Leaving Cer*“icate of Candidate 4) Leaving Certificate of Parent/Guradian 5) Proof of | caste Before 1967 for OBG.6) Last 3-Year Income Certificate issued by NT 7) Resident Proof of Sarpanch/Talathi/Police PatilNNagar Sevak This isto certify that Nagpur Taluka ra belongs tothe ised as Other Backward : tm time to time 2 /E a e ide[s] in Vilage Nagpur 5 ie of the State of | 3. This is to certify that es not belong to the Persons! Sections (Creamy Layel 29-01-2004, & Instructions & Guidlines aid in the Government Resolution Social juste, A lo. CBC.1094/CR-85/BCW-V Dated 16/06/1994) 11 {/BCW-V Dated 29/05/2003 & 3 3 a a 5 & 5 8 : & 3 4, This Certificate is Valid Upto 31/3/2014 |, Dy.Coll OBC RegiCaseNo — 732630130042013 /Year 02-05-2013 Outward No Rev.Case No. 730630130042013 /MRC-81/20122013 Dated 02-05-2013 | Place Nagpur Date: 02-05-2013 A iret 1. ATS ) vas sé =H OCUMENTS VERIFIED ahr 1 oq Verified by Sign. 7365IN THE COURT OF DY. COLLECTOR,NAGPUR € y $ Rev.Case No. 730630130042013 / MRC-81/2012-2013 Kumar SURAJ DEEPAK WANVE 5. This certificate is further extended for the period upto 31/3! 15 —_ from the date of issue. ‘Outward No Fo Dy. Collector | bee Nagpur 6. This certificate is further extended for the period «oto 31/3/ 1 & from the date of issue. Outward No: es Dy. Collector. ————_| Dae: aa iulaavdy . = . 5. MESHRAM | ty “ i Dy. Collector | é gan. Nagpur | 7. This certicate is fut eur outward No / | Collector Place: =~ a . Nagpur | | Piece : Dy. Collector } ae s Nagpur