I

1-2003

GCP-26-3-3,30,000 Cps.-29'1
R.Dis,.......... .....".....1200

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District Code
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Taluk Code
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Village Code

62056L4

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6la,a4b AfiuLL Afi6tit6tr E6Dg gt6ap, bffdr 1!)-7'199-t otfrar,e -r*.......-8.*-......,r,4-,
Alrtr. t Ailafir,rlr;r.d ,+ni$gavi aeni orretpai)a,a,uu@GpEl
..........Son i Daughter of
This is to certify tha1..............

Thiru...........

.................of..........................

" ]:::i':-:

,,"i,,.i ;; ;;;

;i,i;

;lill;, ';;;

;"i;;s, ,;

..........Community, which is recognised as

a Backward Class as per Government Order (Ms.) No.28, Backward Classes

and Most Backward Classes Welfare, dated 19th July

vlde Serial No............... ... .i-/
2 9rA. I 9A,"9 lGeetercar lGea.-af).............

1994

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Q,irr.l:fi6,ar:,y;al$@et: arFtfigl a:Ll5Gtpnnaer areva arier,r'grcftsauu@@pg1.

2.

lt is certified that

Thiru/Tmt./Selvan/Se1vi.................

at...............
.........Ta1uk
r . ,\
c:rtGuquutt
Signature
\

hisiher family ordinarily resrde(s)

Town..

........ and

...,...............Vi11a9e/
....District of
.
:

Gqary: *,
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DEPUTY TAHSILOAB
usrn :
Designation,: I(ALKI'[-AM

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