FORM 'X' to SRO 294 Dated 21-10-05 OFFICE OF THE TEHSILDAR CERTIFICATE OF BEING A MEMBER OF SOCIALLY AND EDUCATIONALLY BACKWARD CLASS. This is to certify that Shri./Smt. _____________________________ S/o D/o _____________________________________________________ R/o____________________________ Tehsil _______________________ District _______________________________________ is a member of Socially and Educationally Backward Class, Failing under the category : i. Resident of the Backward Area. ii. Resident of area adjourning Line of Actual Control. iii. Week and Under privileged class (Social Caste). This is to certify that the said Shri ___________________________ or Shri ______________________________( on behalf of the applicant) submitted his application for grant of this office on _________________ and the certificate has been delivered to him under my hand and seal today on the _____________. This certificate shall remain valid for period of five years from the date of issue of this certificate. Signature of Competent Office with Seal . Name ( in Block Letter) _________________________ Designation : __________________________________ Date __________________________
