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DECLARATION BY THE CANDIDATE IN LIEU OF GEN« CERTIFICATE aoe Name of the candidate: ae aa Address: sword not, Baldo vf Bikes Arplienton Numberet TEE (Main) 2028: (5303) 5] 3g) | a Montene S230682803 “tyat botdpankay Se? @ ume cen 1 understand that ak per the now -guideline from, the Ministry of Peniorinel. Public Gricvances and Pearions, Gol, | am required to submit GEN-EWS cenificate issued on or-after April |, 2023. ‘Sige I have not been able to kolléet the said certificate on tie, I may kindly beallowed 4g write JER (Advanced) 202% proviaionally. I hereby declarp that U wrote JEE (Main) 2023 as WS candidate aad thst | ill uploed a free eertifionte (essed 0 oF aflet April 1, 2023) af the time of reporting nfter scat ablocation, Tiunderatand that inabifity'to upload the same by the grven date and time. wall ead 10 the withdrawal of GEN-EWS benefit, lalso understand thal, if qualified. iny calegory will BE adjusted secordingly’ m the Gommmon Rank List a Se Signature of Father/Mother ‘Signature of Appligait Name: Sunil, Kuro Date ue: (05/202 SST Ta 2S Se

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