GOVERNMENT OF ODISHA

Office of the Tahasildar Keonjhar

Miscellaneous Certificate Case No: E-SEB/2023/396835
ANNEXURE-'C'
FORM OF CASTE CERTIFICATE FOR SOCIALLY AND EDUCATIONALLY BACKWARD CLASSES OF THE STATE

This is to certify that Shri SANTOSH KUMAR MAHANTA son of Smt PRAMILA MAHANTA and Shri
DHRUBA MAHANTA of village Jajapasi P.S. KEONJHAR SADAR , district KENDUJHAR in the State of
Odisha belongs to the Kudumi community which is recognized as a Socially and Educationally Backward
Class under the Government of Odisha, Department of Tribal Welfare Resolution No. 11177 Emp. (Vii)-M-
23/93 dated : 01. 05. 1995 (W) published in Odisha Gazatte(Supplement) No.40 dated 1-10-93.

Shri SANTOSH KUMAR MAHANTA and his family ordinarily reside(s) in the KENDUJHAR District of the
State Odisha.

This is also to certify that he does not belong to the persons/sections (Creamy layer) mentioned in column
3 of the schedule appended to the office memorandum No.4030/ dated 29-1-1992, EMP (VII)92-93.

dgSign2031LocnDyna

Signature of the Revenue Officer

25/07/2023

**** This is a Computer Generated Statement And Does Not Require a Signature ****
NOTE:

(i) It is a digitally signed electronically generated certificate and therefore needs no ink-signed signature.
(ii) This Certificate is issued as per sections 4, 5,& 6 of the Information Technology Act 2000 and its subsequent amendments in 2008
and as per Revenue & Disaster Management Department Notification number IMU-13/10-4251/R&DM.
(iii)For any Query or Verification, Agency /Department / Office may visit https://edistrict.odisha.gov.in
(iv)Tampering with this Certificate will attract penal action.

Reference No: E-SEB/2023/396835 To View: https://edistrict.odisha.gov.in/t/U2LLd/8206484F Token No: 8206484F