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Certificate No. 9546/2018
Taluka Panchayat Una
Gir Somnath

Date 07/07/2018
Government of Gujarat
Performa of Caste Certificate For Scheduled Caste Candidates
Form of Certificate to be Produced by a Candidate Belonging to Scheduled Caste in Support ofthe Claim

FORM OF CASTE CERTIFICATE

This is to certify that Shree KULDEEP TRIKAMBHAI SANKHAT
Son of TRIKAMBHAI

ofVilage Bhacha

inTehsil: Una of District: Gir Somnath of the State Gujarat

belongs to Hindu Vankar

Caste which is recognised as a Scheduled Caste

Under The Constitution (Scheduled Caste) Order, 1950; The Constitution (Scheduled Tribes) Order, 1950;
The Constitution (Scheduled Caste) (Union Teritories) Order, 1951:The Constitution (Scheduled Tribes) (Union Teritories) Order, 1951:
As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) Order, 1956, the Bombay Reorgnisation Act. 1960, the
Punjab Reorganisation Act, 1966, The state of Himachal Pradesh Act, 1970, The North Eastern Areas (Reorgnisation Act, 1971) and the
Scheduled Castes and Scheduled Tribes orders(Amendment ) Act,1976
The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956,
The Constitution (Andaman and Nicobar Islands) Scheduled Castes Order, 1962;
The Consttution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962;
The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962
The Constitution (Pondicheryy) Scheduled Castes Order, 1964;
The Constitution (Scheduled Tribes (Uttar Pradesh)) Order, 1967;
The Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968;
The Constitution (Goa,Daman & Diu) Scheduled Tribes Order, 1968;
The Constitution (Nagaland) Scheduled Tribes Order, 1970;
The Cons.tution (S kkim) Scheduled Castes Order, 1978,
The Constution (Sikkin, Scheduled Tribes Order, 1978;
The Constitution (Scheduled Castes) Order (Amendment) Act, 1990;
The Consttution (Schedtuled Tribes) Order (Amendment) Act, 1991;
The Constitution (Scheduled Tribes) Order( Second Amendment) Act, 1991;
The Constitution (Scheduled Tribes) Ordinance, 1996,
The Consiution (Scheduled Castes & Scheduled Tribes) Order (Amendment) Act, 2002;
The Constitution (Scheduled Castes) Order (Amendment) Act, 2002
The Constilution (Scheduled Castes) Order (Second Amendment) Act, 2002.

Shree KULDEEP TRIKAMBHAI SANKHAT and his/her Family ordinarily reside(s)

in yilage Bhacha in Tehsil Una

OrDsuict Gir Somnath of the State Union Territory of Gujarat

Tnis Certficate is issued on the basis of following proofs

1 True Copy of Birth Certificate 2 True Copy of School Leaving Certificate

3 Income Cerificate 4 Ration Card

5 Affidavid attached with the application 6 True Copy of School Leaving Certificate of
Father/Brother/Sister

Note : The Terin 2oreitayreside(s) used here will have the same meaning in Section 20 of the Represhtationof the Peoples Act, 195

Nn'mbe
Taluka Developement Officer
ptfice sea Taluka Panchayat Una

Guiarat Diaital Guiarat

lCourtesv .: National Inlomatics Centre.