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GOVERNMENT OF ANDIIRA PRADESH
REVENUE DEPARTMENT
Application No
om
€GC011922201799
Date : 27/05/2019
—
COMMUNITY , NATIVITY & DATE OF BIRTH CERTIFICATE
L This 45 to certify that the Sn/Srimathi, Kumari kethipatli bharathi S/o / D/o / M/o / F/o /Wlo/ Hfo/ Cfo
Sn Kuparae of RACHAMALLIPADY village / Town of Yeldurthy Mandal of Guntur Dvstnct of the State
Andhra Pradesh belongs to Magliaa-1C) Community / Caste wich 1s recagnizec as Scheduled Community
Sasttution (Scheduled Tribes) Order, 1950, $ Cs, STs lst Mourcation) order 1956
Caste under The
and S Ts (Amendment) Act 1976 as Amended from time
7 IVS ceeitieg tat the Sr/Srmathi/kumar: Kethipall bharath! 1s @ naive of By CHAMALLIPADU village
Mate Anat ry Prati sis
to nme
Toon of e'dar ot Syngue strict of tn
2s cemies that the place of 8th Sn/Simatnikumarl Kethipalli Bharath) 1s of MALLIPAD:
Wage | Town of Veldurthy Mandal of Guntur District of the State Andhra Prades
411s cemtted that the Date of Btn Sr/Srmath/Kumari kethlpalli Bharathi 1s 19 Day December tonth
2008 Year On wroras) QneNine = December - Twa Zere Zero Eiaht as per the deciaration given by his/her
Father/Mother/Guardian and as entered in the School recoras where he/she studied
Certified By
Name : G.S.MPrasad
Designation : TAHSILDAR
Mandal : Veldurthi
Feaure physeal signature And tha vcrtteate can be vented at
Note ths 8 Ontaly Saned Certfcate, does not
anpleation number mentaned in the ~erteeate
NED ‘ieveiw ap meeseva que wv by fuenghing the
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