Format For Caste Certificate For SC/ST Candidates: Annexure I

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Annexure I

FORMAT FOR CASTE CERTIFICATE FOR SC/ST CANDIDATES

This is to certify that Shri*/ Shrimati/ Kumari*......................................son/ daughter* of ............................ Village/Town


....................................../ District / Division*..................................................................of the
......................................State I Union Territory* belongs to the......................................Caste*/Tribe which is recognised
as a Scheduled Caste I Scheduled Tribe under:
@The Constitution Scheduled Castes Order 1950.
@The Constitution Scheduled Tribes Order 1950.
@The Constitution (Scheduled Castes) (Union Territories) (Part C States) Order 1951;
@The Constitution (Scheduled Tribes) (Union Territories) (Part C States) Order 1951;
[As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification Order 1956, the Bombay Reorganisation Act 1960, the Punjab Re-
organisation Act 1966, the State of Himachal Pradesh Act 1970, the North Eastern Areas (Re-organisation) Act 1971 and the Scheduled Castes and Scheduled
Tribes Orders, (Amendment) Act 1976]
@The Constitution (Jammu and Kashmir) Scheduled Castes Orders, 1956
@The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959 as amended by the Scheduled Castes and Scheduled Tribes Orders
(Amendment)Act, 1976
@The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962.
@The Constitution (Dadra and Nagar Haveli) Scheduled Tribes, Order, 1962.
@The Constitution (Pondicherry) Scheduled Castes Orders, 1964.
@The Constitution (Uttar Pradesh) Scheduled Tribes Order, 1967.
@The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968.
@The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968.
@The Constitution (Nagaland) Scheduled Tribes Order, 1970.
@The Constitution (Sikkim) Scheduled Castes Order, 1978.
@The Constitution (Sikkim) Scheduled Tribes Order, 1978.
@The Constitution (Jammu & Kashmir) Scheduled Tribes Order,1989.
@The Constitution (SC) Orders (Amendment)Act, 1990.
@The Constitution (ST) Orders (Amendment) Ordinance Act, 1991.
@The Constitution (ST) Orders (Amendment) Ordinance Act,1996.
@The Constitution (Scheduled Castes) Orders (Amendment)Act, 2002.
@The Constitution (Scheduled Castes) Orders (Second Amendment) Act, 2002.
@The Scheduled Castes and Scheduled Tribes Orders (Amendment)Act, 2002. As amended from time to time.
% 2. Applicable in the case of Scheduled Castes/Scheduled Tribes persons who have migrated from one State/Union Territory Administration to
another.

This certificate is issued on the basis of the Scheduled Castes / Scheduled Tribes Certificate issued to
Shri/Srimati*...............................father/mother*of Shri/Srimati/Kumari...............................of
Village/Town*...............................in/District/Division*...............................of the State/ Union
Territory*……………………………………who belongs to the Caste* /Tribe which is recognised as a Scheduled Caste/Scheduled
Tribe in the State/Union Territory* issued by the………………………dated.
%3. Shri/Srimati/Kumari*...............................and/or* his/her* family ordinarily resides in Village
Town*...........................District/Division*......................of the State/Union Territory* of ...............................
Place............................... Signature.........................................
Date............................... Designation .....................................
(with seal of Office)
State/Union Territory........................
*Please delete the words which are not applicable.
@ Please quote the specific presidential order.
% Delete the Paragraph, which is not applicable.
Note: (a) The term "ordinarily reside(s)" used here will have the same meaning as in Section 20 of the Representation of the People Act,
1950.

Officers competent to issue Caste/Tribe certificates:


1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner/ Deputy
Collector/ 1st Class Stipendiary Magistrate / City Magistrate/ Sub-Divisional Magistrate / Taluka Magistrate/ Executive Magistrate /
Extra Assistant Commissioner (not below the rank of First Class Stipendiary Magistrate). 2. Chief Presidency Magistrate / Add itional
Chief Presidency Magistrate / Presidency Magistrate. 3. Revenue Officers not below the rank of Tehsildar. 4. Sub-Divisional Officer of
the area where the candidate and /or his/ her family normally reside(s). 5. Certificates issued by Gazetted Officers of the Central or
of a State Government Countersigned by the District Magistrate concerned. 6. Administrator /Secretary to Administrator
(Lakshadweep, Andaman & Nicobar Islands).

CEN No. 03/2024 Page 22 of 73

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