AA Apagetort

mee seva
0OYY 99920971

GOVERNMENT OF TELANGANA
REVENUE DEPARTMENT
FORM III A
Cemmunity Serial No : 4
SC Application No
District Code: 23
Mandal Code : 34
CNDO21501428378
Village Code :020 Date : 29/05/2015

COMMUNITY AND DATE OF BIRTH CERTIFICATE

1.This is to certity that the
Sri.
BOORUGU_ MABAIAH
District of the Telangana
Sri/Srimathi/Kumari gooRUGURANI S/0 / D/o / M/o / F/o / W/o / H/o/ C/o
of
NALGONDA (URBANL village / Town ofMalaenda Mandal of Nalsenda
State State belongs to Mela-34SC) Community which is recognized as S.C

under
The Constitutuion (Scheduled Castes) Order, 1950
The Constitutuion (Scheduled Tribes) Order, 1950
G.O.Ms.No.1793,Education, dated 25-9-1970 as amended from time to time (BCs) S.Cs.,S.Ts.list
(Modification) Order,1956,S.Cs and s.T.s(Amendment) Act, 1976.

2.It is certified that the date of birth Srysrimathi/Kumari BOORUGU RANIL IS day 04 Month 2ULY Year

1999 (in words) ZeroEourJUAY-One Nine Nins Zero as per the declaration given by his/her
Father/Mother/ Guardian and as entered in the School records where he/she studied.

certifed By

Name : YARALA ASHOK REDDY

Designation : TAHSILDAR
Mandal : Nalgonda
Note : This ts Digitally Signed Certincate, does not require physical signature. And this certifcate can be verified at
p g-meeseva.gov.iny by urnishing the application number mentioned in the Certificate.

htps://tgasp.meeseva.gov.in/APSDCPortal/Userinterface/citizen/RevenueServices/Comm. 5/30/2015