N2RATGOSIOTOS1BASABS FORM "C" [Soe Rule 4(6) and §(2) (a) and (o Form of Scheduled Tribe Certficate (For Ordinary residents of Maharashira) Outward No: 39561195486 ‘Application Date = 30/08/2019 Rev Case No MRC + 99561195486 This isto certify that ShrShrimatiKumari Nikita Chaltram Pawara Daughter of Chaitram Gansha Pawara of Vilage/Town Malkatar taluka Shirpur, in Distric/Division Dhule of the State belongs to the Pawra tibe Sr.No. 8 which is recognized as a Scheduled Tribe under. ‘The Constitution (Scheduled Tribes) Order, 1950 [As amended by The Scheduled Castes! Scheduled Tribes Lists (Modification) Order, 1956, The Bombay Reorganisation Act, 960] ‘The Constitution Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976 (No.108 0f 1976), ‘#The Constitution Scheduled Castes and Scheduled Tribes Order(Amendment) Act, 2002 (No.10 of 2003), 2. Shi/Shrimati/Kumari Nikita Chaitram Pawara andlor her family ordinarily reside( Vilage/Town Malkatar taluka Shirpur, of Dhule DistriclDivision of the State of Maharashtra. [avoreate to ‘grants yahin | APptcabe nthe caso of Scheduled Tribes parzons who have rated fom one Distt to snother 1 Manarashia Distt win te MaharashivaStte) State == oF ShiiShrimatidumarl_—__ of VillagefFown Distie¥Division "of whe belongs. ‘Signature valid Digital ied by Vikraraygant Banda Date:0898-2019 6:34:18 PM Pisce + Shinar Vikram Vasant Bandal Deve : o6roer2010 (vith te sat of ce) Sub Divisional Officer Shirpur 1 ‘igtaly signed document, hence is lagaly val as per the Information Technology (7) Ad, 2000. ‘overt vat hips tw mahsonine govinvesly OR SMS "NH«space>CSCeepace>VRFY<20 di Barcode mumber"to 165 frm a BSNL, MTNL Tata Mebieand @ scanned with OKEN Scanner