SourceAnnual Income (Rs)Agriculture: Salaries: Any other source(s) (to be specified) : 2.This certificate being granted only for the purpose ofSignature of Revenue Officer Designation (with seal of office) Signature of the Applicant Office of the Miscellaneous Certificate Case No. This is to certify that Shri/Smt./Missis a resident of Village/Town(address) P.S. Tahasil in the District of Income of Rs. /-(Rupees Date: Please affix required stamps before submissionApplication Form for Income Certificate Published on National Portal of India (india.gov.in) REVENUE & LAND REFORMS DEPARTMENTJHARKHAND GOVERNMENTof 20 )only from the sources specified below sondaughterwifeof Shri /in the State of Orissa has an Annual