AFFIDAVIT FOR CASTE CERTIFICATE

I AM ENCLOSING ANNEXURE III FORM OF CASTE CERTIFICATE ALONG WITH THIS AFFIDAVIT
I, NAKKA SURI BABU, S/o VENKATESWARA RAO, AGED 35 YEARS, resident of H.NO. 1-20-28,
BHOGESWARAM RAOS, Kotha Colony, Kalidindi, Kalidindi Mandal, Eluru District, A.P. at present I
came to Bhimavaram to take this notary, do hereby solemnly affirm state on oath as follows.
1. I am an Indian.
2. I am fully acquainted with the facts of this affidavit. I am applying caste certificate.
3. I am representing on behalf of my daughter, who is minor her name is NAKKA SIRISHA. Her
date of birth is 15/02/2011 ( one, five, zero, two, two, zero, one, one).
4. We are belong to Indian Hindu Schedule Caste Mala (S.C) community , now I would like to
apply caste certificate to her favour. This is necessary for her school admission. My
forefather are belong to Hindu Mala community we worship Hindu idols Hindu festivals After
making an enquiry kindly issue Caste Certificate. To show our caste my wife and my daughter have caste
certificate here with enclosing.
5. I am enclosing Panchanama statement our local elders 5 people, and my wife certificate.
If any discrepancies arise in future regarding the contents mentioned in the above affidavit, will be held liable for the action taken
by the concerned authorities.

Applicant Deponent
Solemnly affirmed and signed before me on this 17/07/2023 at Bhimavaram , West Godavari District, A.p. India.