FORM No.

III
(See Rule 3)
GOVERNMENT OF ODISHA
Office of the Tahasildar Hatadihi
Miscellaneous Certificate Case No E-INC/2024/342549
INCOME CERTIFICATE
(Valid for the Financial Year 2023-2024)

This is to certify that Shri BISWARANJAN PALATA son of Smt ASHALATA PALATA and Shri RANGADHAR
PALATA, is a native/permanent resident of the district of KENDUJHAR in the state of Odisha and he or his family is
presently residing at Village/town Similia P.S NANDIPADA Tahasil Hatadihi in the district KENDUJHAR of in the
state of Odisha has an annual family income of Rs. 61000.00 (Rupees Sixty One Thousand ) only from the sources
specified below.
Sl Income(in
Source
No. Rs.)
Agriculture (including plantation, horticulture, dairying, poultry,
1 fisheries etc.)
11000.00

2 Salary/ Wages/ Renumeration etc. 0.00

3 Trade/ Business/ Profession (Please Specify) 0.00
4 Other Sources(Please Specify) 50000.00
Total 61000.00

dgSign2031LocnDyna
Signature of the Revenue
Officer
17/03/2024

**** This is a Digitally Signed Document And Does Not Require 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 section 4, 5,& 6 of 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 of this Certificate will attract penal action.

Reference No: E-INC/2024/342549 To View: https://edistrict.odisha.gov.in/t/B4O1e/635A58E8 Token No: 635A58E8