FORM No.1 (See Rule 3) GOVERNMENT OF ODISHA Office of the Tahasildar Cuttack Miscellaneous Certificate Case No€-SCO/2021/101854 SCHEDULED CASTE CERTIFICATE This is to certify that Miss SUBHASHREE BEHERA daughter of Smt HENA BEHERA and Shri NATA KISHOR BEHERA, of village/town BIDANASIP.S BIDANASI in the district CUTTACK in the | state of Odisha belongs to Kalbarta caste which is recognized as Scheduled Caste Under the constitution (scheduled Caste / Scheduled Tribe) order 1950 as amended by the scheduled Caste and Scheduled Tribe List (Moditication) order 1956 and Scheduled Caste and Scheduled Tribe Order (Amendment) Act, 1976, | Miss SUBHASHREE BEHERA and her family ordinarily reside(s) in village/town BIDANASI of CUTTACK district in the state of Odisha. gtaty sas by BANANI MOHAPATRA Daeztat as 207 9090 520, Signature of the Revenue Officer 12/05/2021 | == This ea Digital Signed Document And Does Not Require Signaiure == NOTE | (i) Wis a digitally signed electronically generated certificate and therefore needs no ink-signed signature. (i) This Certificate is issued as per section 4, 5,8 6 of Information Technology Act 2000 and its subsequent amendments in 2008 and as per Revenue & Disaster Management Department Notification number IMU-13/10-4251/R&DM. i) For any Query or Verification , Agency /Department / Otfice may visit htps:/edistrct.ocisha.gov.n (iv) Tampering ofthis Certificate will atract penal action. Reference No: E-SCO/2021/101854 To View: hitpe:editril odigha.gov InTDKB/AS6742A2 Token No: ASB742A2