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FORM ­ 8
[Rule No. 5 (6)]
Form of Caste Certificate for De­Notified Tribe (Vimukt Jati)/Nomadic Tribe/Other Backward
Class/Special Backward Category person belonging to the State of Maharashtra

Documents Verified
1 Copy of School Leaving Certificate Of Grandfather Issued By ­ N P Prathamik shala,Amalner Reg No ­ 32
.
2 Copy of School Leaving Certificate Of Father Issued By ­ G S High school,Amalner Reg No ­ 15804 Date ­
. 21/11/2000
3 Bonafide Of Beneficiary Issued By ­ Shri Ravindra Sahebrao Patil prathamik Vidya mandir,Amalner Reg No ­ 4243
. Date ­ 04/08/2023
4 Hamipatra Issued By ­ VLE
.
5 Shapatpatra Issued By ­ Applicant
.

CASTE CERTIFICATE

Outward No : 39691326769 Application Date : 11/08/2023

Rev Case No : MRC : 39691326769

This is to certify that Kumar Niraj Manohar Bari Son of Mr. Chavhan Manohar Dharma of Village
Amalner (M Cl), Tehsil Amalner, in the District Jalgaon of the State of Maharashtra belongs to the
Bari Caste which is recognised as Other Backward Class at Sr No. 13 under Government
Resolution CBC­1467/M dated 13/10/1967 as amended from time to time.

Kumar Niraj Manohar Bari and/ or his family ordinarily resides in Village Amalner (M Cl), Tehsil
Amalner, in the District Jalgaon of the State of Maharashtra.

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r Digitally Signed by
Amalne Mahadev V. Khedkar
Date:2023-08-28 1:43:51 PM
Place : Amalner Sub Divisional Officer
Date : 27/08/2023 (With the seal of Office) Amalner

Printed By ­OMTID : VLE Name :Kishor Mukundarao Suryawanshi, Date:27/08/2023 11:47PM

This is a digitally signed document, hence is legally valid as per the Information Technology (IT) Act, 2000.
To verify visit https://www.mahaonline.gov.in/Verify OR SMS “MH<space>CSC<space>VRFY<20 digit Barcode number>” to 166 from a BSNL, MTNL, Tata Mobile and
51969 from others.