GCP 26-4-5,40,000 Cps13-9-2007 [P4-13]

R.Dis 167|12- 1200 Dated 200

IDM ('u$G) 61607
District Code
SC
Taluk Code
Certificate No
gTID G u i G 6163
Village Code oo7]
COMMUNITY CERTIFICATE
GGag?. LDTOLLO.... ***

55UUOTT*lsora
******************T***********
onb ****
***********

6T6 m6 DatisÚUGRngJ
....Son / Daughter of
This is to certify that..
Thiru.. **************** *

Village TownA.. aluk..

Nadu belongs to
*********'***°********°******
he State of Tami
Community,which is recogised as
Scheduled Caste as per the Schediled Castes and Scheduled Tribes Orderss
(Amendment) Act, 1976 vide Serial No..
2. DyuB/asáaa ftar

gprirsen croiré ancrgefiásinigBng

2. is ocertified that Thiru/Tnt /Selvan/Selvi.. a n d

his/her famly rdinarity resides} at.. ....illage/Town

... Taluk ....District of
Tamil Nadu.

Seay .
*** GmsuTÚLND
.*
Signature
Date AdLILSut
UÁEIKafai)
Name (fn Capital Letters)
Designation