FORMAT FOR SELF DECLARATION AND UNDERTAKING

TO BE PRODUCED BY GENERAL – ECONOMICALLY WEAKER SECTION

CANDIDATES
IN LIEU OF GEN-EWS CERTIFICATE

I understand that as per the new guidelines from the Ministry of Personnel, Public
Grievances and Pensions, GoI, I am required to submit GEN-EWS certificate issued on or
after April 1, 2023.

I___________________________________________________ Son/ Daughter of

____________________________________________
belong to the ___________________________Caste in ___________________________ state which is not
recognized as a Schedule Caste, Schedule Tribe and Other Backward Classes (Central
List [http://www.ncbc.nic.in]).

I hereby declare that I will upload the GEN-EWS certificate (issued on/after April 1,
2023) latest by 06 June, 2023 for ICD/BE Lateral Entry, M.Sc/ M.Tech/ Ph. D.

I understand that inability to produce the same by the above mentioned date will lead to
the withdrawal of GEN-EWS benefit.

Signature of Father/Mother Signature of Applicant

Name: Name:
Date: Date:
 FORMAT FOR EWS CERTIFICATE
(ISSUED ON OR AFTER 01.04.2023)

Government of _______________
(Name and Address of the authority issuing the certificate)
INCOME & ASSET CERTIFICATE TO BE PRODUCED BY ECONOMICALLY
WEAKER SECTIONS
Certificate No.___________
Date:______________

This is to certify that Shri/Smt./Kumari_____________________________son/daughter/wife

of Sh._____________________________ permanent resident of
___________________________ Village/Street _________________ Post
office______________________ District in the State/Union Territory
______________________________PIN code___________________ whose photograph is
attested below belongs to Economically Weaker Sections. Since the gross annual income* of
his/her family** is below Rs.8 Lakh (Rupees Eight Lakh only) for the financial
year____________________. His/her family does not own or possess any of the following
assets***:
i. 5 acres of agricultural land and above;
ii. Residential flat of 1000 sq.ft and above;
iii. Residential plot of 100 sq.yards and above in notified municipalities;
iv. Residential plot of 200 sq.yards and above in areas other than notified municipalities.

Shri/Smt./__________________________________ belongs to the ________________caste

which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward Classes
(Central List).

Recent Passport
size attested
photograph of
the applicant Signature with seal of office___________
Name____________
Designation____________
* Income covered all sources i.e. salary, agriculture, business, profession etc.
** The term “Family” for this purpose include the person, who seeks benefit of reservation, his/her parents and siblings below the age of 18 years and
also his/her spouse and children below the age of 18 years.
*** The property held by a “Family” in different locations or different places/cities have been clubbed while applying the land or property holding test
to determine EWS status.
The authorities competent to issue EWS Certificates are indicated below:
(i) District Magistrate / Additional Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector / Ist Class
Stipendiary Magistrate / Sub-Divisional magistrate / Taluka Magistrate / Executive Magistrate / Extra Assistant Commissioner (not below the rank
of Ist Class Stipendiary Magistrate).
(ii) Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.
(iii) Revenue Officer not below the rank of Tehsildar’ and sub-Divisional Officer of the area where the candidate and / or his family resides.