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FORM OF CASTE CERTIFICATE FOR SC/ST

This is to certify that Shri*/Shrimati/Kumari*………………………………………..……….Son /daughter* of…………………………………..………..


Village/Town …………………………………../ District/Division*…………………………………………………. Of the ……………………………….State/
Union Territory* belongs to the………………………………………………….Castes*/Tribe which is recognised as a scheduled Castes /
Scheduled Tribe under:
@The Constitution Scheduled Castes Order 1950.
@The Constitution Scheduled Tribe Order 1950.
@The Constitution (Scheduled Castes) (Union Territories) (Part C States) Order 1951;
@The Constitution (Scheduled Tribe) (Union Territories) (Part C States) Order 1951;
[As amended by the Scheduled Castes and Scheduled Tribe 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 Tribe Order, (Amendment) Act 1976]
@The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956
@The Constitution (Andaman and Nicobar Island) Scheduled Tribe Order, 1959 as amended by the Scheduled Castes and
Scheduled Tribe Order (Amendment)Act, 1976
@ The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962.
@ The Constitution (Dadra and Nagar Haveli) Scheduled Tribe Order, 1962.
@The Constitution (Pondicherry) Scheduled Castes Order, 1964.
@The Constitution (Uttar Pradesh) Scheduled Tribe Order, 1967.
@The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968.
@The Constitution (Goa, Daman and Diu) Scheduled Tribe Order, 1968.
@The Constitution (Nagaland) Scheduled Tribe Order, 1970.
@The Constitution (Sikkim) Scheduled castes Order, 1978.
@The Constitution (Sikkim) Scheduled Tribe Order, 1978.
@The Constitution (Jammu & Kashmir) Scheduled Tribe Order, 1989.
@The Constitution (SC) Order (Amendment) Act, 1990
@The Constitution (ST) Order (Amendment) Ordinance Act, 1991.
@The Constitution (ST) Order (Amendment) Ordinance Act, 1996.
@The Constitution (Scheduled Castes) Order (Amendment) Act, 2002.
@The Constitution (Scheduled Castes) Order (Second Amendment) Act, 2002.
@The Scheduled Castes and Scheduled Tribe Order (Amendment) Act, 2002.
As amended from time to time.
% 2. Applicable in the case of Scheduled Castes/Scheduled Tribe persons who have migrated from one state/Union Territory
Administration to another.
This certificate is issued on the basis of the Scheduled Castes / Scheduled Tribe 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……………………….…………………………..….castes*/Tribe which
is recognised as a Scheduled Castes/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 reside9s)” used here will have the same meaning as in section 20 of the Representation of the
People Act, 1950.
Officer competent to issue Caste/Tribe certificate:
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 / Additional Chief Presidency Magistrate / Presidency
Magistrate. 3. Revenue Officers not below the rank of Tehsildar. 4. Sub-Division 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 Island).

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