GOVERNMENT OF ODISHA

Office of the Tahasikdar Kanasaa

Miscellaneous Certificate Case No:E-SEB/2021/39727
A
ANNEXURE-C
FORM OF CASTE CERTIFICATE FOR SOCIALLY AND EDUCATIONALLY BACKWARD CLASSES OF THE STATE

This ts to certity that Miss SAAMISTA PRADHAN daughterof Smt BHABANI PRADHAN and Shri
SATYAPRO PRADHAN of vtage BHATAPADA P.S. KANAS, district PURI in the State of Odisha
belongs Khandayat to the community which is recognized as a Socially and Educationally Backward
Class under the Government of Odisha, Department of Tribal Welfare Resolution No. 25455
Emp. (Vi)-
M-23/93 dated 10. 09. 1993 (TW) published in Odisha Gazatte(Supplement) No.40 dated 1-10-93.

Miss SARMISTA PRADHAN and her family ordinarily reside(s) in the PURI District of the Stale Odisha.

This is also to certify that she does not belongs to the

persons/sections (Creamy layer) mentioned in
column 3 of the schedule appended to the office memorandum No.4030/ dated
29-1-1992, EMP (VIN92-
93.

Digitally signed by SAHU SAHADEV

Date2021.02.19 07:3618 +0530
Signature of the Revenue Oficer
19/02/2021

This is a Computer Generated Statement And Does Not Require Signature ****

NOTE
)It is a digitally signed electronically generated certificate and therefore needs
(i) This Certificate is issued as per section 4, 5,& 6 of Information
no ink-signed signature.
per Revenue & Disaster Management Department Notification Technology
number Act 2000 and its subsequent amendments in 2008 and as
IMU-13/10-4251/R&DM.
(i') For any Query or Verification, Agency /Department/ Office may visit
(iv) Tampering of this Certficate will attract penal action. https://edistrict.odisha.gov.in

Reference No: E-SEB/2021/30727 To

View hitp://edistrict.odisha.gov.in//amPtb/B40F49A2 Token No: B40F4BA2