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FORM No. I
{s@ Bute 3)
GOVEBNMENT OF ODTSHA
Oifice ol lhe TahasildarAstaranga
[liscellaneous Cerllf icate Case No E-SCO/2021/'1 791 82
SCHEDULED CASTE CERTIFICATE

This is lo certify that shri BUDHESWAR SENAPATI son ol Smt MINILATA SENAPATI and Shri
DHULESWAR SENAPATI, of village/town JHADALING SAMIL BILUAMUNDALI P.S ASTARANG in
the d strict PuRl in the state of Odisha belongs to Kaibafia caste which is recognized as Scheduled
Casle under the constitution (scheduled Casle / Scheduled Tribe) order 1950 as amended by the
scheduled Casle and Scheduled Tribe List (Irodification) order 1956 and Scheduled Caste and Scheduled
Tribe Order (Amendmeni) Act, 1976.

Shri BUDHESWAR SENAPATI and his lamily ordinarily reside(s) in village,/town JHADALING SAMIL
BILUAMUNDALI ol PUBI district in the state of Odisha.

r tr

Signature of the Revenue Officer

24/07 t2021

I .! rl

'"'i6is G a Digitally slgne.j DocLrment And Does Nor Require siqnaiure '-';

NOTE
(i) lt is a digltally signed eleclronicaily generaled ceftiflcate and lherefore needs no nk sgned sgnal!re.
(ii) Th s Cellilicate is issued as per seclion 4, 5 & 6 oi lnlormalion Technoloqy Ac1 2000 and its subseq!ent amendments n
2008 and as per BeverLre & Disaster Managemert Depa(ment Notification number ll\,11.1-1 3/10-425I /R& DII.
(iiiJ Fot any Ouery or Ver tication , Agency /Department / Ollice may visit htpsr{edistrici.odislra.sov.in
(lv) Tanrperng ol thls Cerllicate willatlract penalacllor.

ReieEnce No:E SCO/2021/l7S1a2To View: htlpsr/edistict odlsha gov.in,VrEyTbl1597MC3 Token No: l5S704Ca