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ANNEXURE C

STUDY CERTIFICATE
( Under Article 371 (J) )
( See rule 4 (C) (2) (II) )

(The Karnataka Public Employment (Reservation in Appointment for Hyderabad Karnataka Region)
Rules for issue of certificate 2013)

This is to certify that Sri/Smt..............

S/o. D/o. W/o.... has been studying in ....

College/SchoolTaluka

District During the period noted below.

S. From which date to which


Class/Level Reference of Documents
No. date

He has passed / Failed following exam during following year


S. Name of the Class/Exam Reference to
Year Failed/Passed
No. Level Documents

Place Name

Date.. Head of the Institution

CERTIFICATE
This is to certify that I have satisfied myself that the certificate given above is true as per
available record.
Place

Date..... Signature

Block Education Officer


..Taluka

.....District

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