Professional Documents
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Signature Designation (With seal of office) PLACE: STATE / UNION TERRITORY : DATE : NOTE- The term "Ordinarily resides" used here will have the same meaning as in Section 20 of the Representation of the Peoples Act, 1950. ____________________________________________________________________________________________ Please delete the words which are not applicable No F101/30/94-SCT(B) dated 10.04.1995
Form Of Certificate to be produced in the case of Scheduled Castes/or Scheduled Tribes persons who have migrated from one State/ Union Territory Administration.
This Certificate is issued on the basis of the Scheduled Caste /Scheduled Tribe Certificate issued to Shri / Shrimathi* ________________ father / mother* of Shri / Shrimathi / Kumari*_______________________ of Village/ Town* ________________ in District/ Division* _______________ of the State/ Union Territory* _________________ who belong to the______________ Caste / Tribe* which is recognised as Scheduled Caste / Scheduled Tribe* in the State / Union Territory* _____________________ issued by the , ___________________________(Name of the prescribed Authority) vide their No. _________ dated __________
Signature Designation (With seal of office) PLACE: STATE / UNION TERRITORY : DATE : NOTE- The term "Ordinarily resides" used here will have the same meaning as in Section 20 of the Representation of the Peoples Act, 1950. ____________________________________________________________________________________________ Please delete the words which are not applicable No F101/30/94-SCT(B) dated 10.04.1995