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గ్రామ – వార్డు సచివాలయము

ఆంధ్రప్రదేశ్ ప్రభుత్వం

Issuance of Income & Asset Certificate for EWS


Applicant Name :
Applicant Aadhar :
Father/ Husband Name :
Ration Card Number : Email ID :
Mobile Number : Date Of Birth :
Gender : Caste : Sub Caste :

Permanent Address :
District : Mandal :
Village : Street Name :
Pin Code : Cluster Number :

Income Certificate Details :


Annual Income :
Gross Income Including Salary, Agriculture, Business, Profession, Etc., For the Financial year prior to the year of Application.

Assets Information :
> 5 Acres Of Agriculture land : Yes / No
> Residential Flat of 1000 sq.ft : Yes / No
Residential Plot of > 100 sq.yards in Notified Municipalities : Yes / No
Residential Plot of > 200 sq.yards in areas other than notified Municipalities : Yes / No

Decleration :
Verify and Tick ( ) the Following.

The term “ Family ” for this purpose will include the person who seeks benefit of Reservation, His/ Her Parents
and Siblings below 18 years as also His/ Her Spouse and Children below the age of 18 Years

I don’t belong to SC, ST, OBC caste

Documents To Be Attached :
1) Application 2) Notary
3) Aadhar, Ration Card 4) Photo

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