FROMDIRECTOR SECONDARY EDUCATIONHARYANA, SHIKSHA SADAN, SECTOR-5,PANCHKULA

TOALL THE DISTRICT EDUCATION OFFICERS,IN THE STATE.

MEMO NO. 15/104-2011 Co (5)DATED PANCHKULA THE: I Cititictx

SUBJECT: "STREAMLINING THE PROCEDURE IN THE OFFICES REGARDING ISSUING OFRESIDENT/INCOME CERTIFICATES AND THE CASTE CERTIFICATE TOSCHEDULED CASTES AND BACKWARD CLASSES" AS PER CHIEF SECRETARYLETTER 22/28/2003-3G.S.III DATED 30.01.2004.

Reference this office Memo No. 15/104-2011 Co (5) dated 08.11.2011 on thesubject cited above.

In the subject matter, the Chief Secretary Haryana has issued time boundscheduled regarding issuing of Resident/Income certificates and the Caste certificate toScheduled Castes and Backward Classes". However, it has come to the notice that theseinstructions are not being adhered to by the Heads of Institutions causing hardship to thestudents. Therefore, it is directed with a copy of Chief Secrteary Letter 22/29/2003-3G.S.IIIdated 30.01.2004 to get these instructions implement from all the Heads of Institutions underyour control . The relevant portion of said instructions is reproduce as under:-"5. To make institutional arrangements, it has also been decided that In future the Resident andCaste certificate will be issued to all the students studying in class 8 th every year as per the timeschedule given be low:- To make institutional arrangem6nts, it has also been decided that infuture the Resident and Caste certificates will be issued to all the students studying in class 8thevery year as per the time schedule given below:-

Filling of application form by the parent s/students.1st Nov. to 10th Nov. every year.Verification by

Sarpanch/Nambardar in case of rural areas and Municipal Councillors in case of urban areas.Verification by Patwari in case of rural areas/ED/Secy. (MC) any other officer/officialauthorized by the local body for the purpose in case of urban areas. ' Upto 15th Novemberevery year. 30 th November.

(f) Head Teacher/Head Master upto 15 th Dec.Forwarding of application to CRO by Head Teacher/Head Master 31 st Sec.Verification & issue of certificate by CRO upto 31 st January every year.

All application forms of a particular school may be sent to the Tehsildar/Naib Tehsildarconcerned preferably at one go so that the certificates are Issued and sent back to theHeadmasters of Government Schools/Private Schools for distribution to the concernedstudents. The Head Teacher/Headmaster shall be responsible for getting the applicationforms filled and files prepared of all the students presently studying in Class-VII to XII will beissued these certificates during the months of January, 2004 to March, 2004. The schedule willbe finalized by the concerned Deputy Commissioner in this regard.It has been further decided that in case of SC/BC students claiming benefit under variouswelfare schemes upto Class IX, the benefits will be given by the Head Master/Head Teacherafter getting the verification done from Sarpanch/Nambardar/MC and a caste certificateissued by the CRO (Tehsildar/Naib Tehsildar) may not be demanded for this purpose by theSchool authorities".

The above instruction may be complied strictly in accordance of ChiefSecretary. If any complaint received in this regard, strict disciplinary action will be takenagainst the officer.

Please give it top priority.

l/

,-- ,iA,SI'rtt,,t SUPERINTENDENttN

T CO-OR e

INATIONFOR DIRECTOR SECONDARY EDUCATION

._ HARYANA PANCHKULA1 fr

No. /28/2003-30.

The Chief Secretary to Government Haryana.

From

h)

Subject;-

Sir.,

All the Heads of Departments in Haryana.

The Commissioners, Rohtak, Gurgaon, Hisar and AmbalaDivisions.

The Registrar, Punjab and Haryana High Court,Chandigarh.

All the Deputy Commissioners in Haryana.

5. The Registrars, Maharishi Dayanand University, Rohtak.- Kurukshetra University Kurukshetra, Ch. Charm Singh

Haryana Agriculture University, Hisar ,Guru JambeshwarUniversity, Riser & Ch. Devi La! University Sirsa (Haryana),

Dated, Chandigarh, the 30th, January, 2004.

Streamlining the procedure in the offices regarding issuingof Resident /Income Certificates and the caste certificate toScheduled Castes and Backward Classes.

***

am directed to invite your attention to Haryana Governmenti etters Nos. 62/17195-2G.S.1.11, dated 0310.96, No. 22/51/93-3G.S.111, dated 12,08.93

and even No. dated 14.10.97 on the subject noted above wherein instructions

regarding the caste certificates (SCBC/OBC). and Resident certificates have beenissued.

The policy has been reviewed keeping in view the variouscourts judgements and the hardships caused to the individuals in obtaining above

quoted certificates. Government is of the view that the promdure . he institutionalizedby delegating powers at proper level for ensuring .spe..edy disposal of work withoutany harassment or exploitation. The present modification of the policy also aims atsimplifying the procedure for obtainingvertificate by an individual falling under thereserved categories:

1The matter has also been reconsidered in depth by the State

Government in view of the problems being faced by the Government employees inobtaining these certificates, With a view to improve the existing system in issuing

carious certificates, it has been decided by the Government that henceforth CircleRevenue Officers (fehsildar/Naib Telisildar-cum-Executive Magistrate) concernedwill he authorized to issue Resident as well as Caste Certificates (SUB('/013C) after

getting the verification done through the subordinate revenue staff in case of

applicants residing in the rural area and through the Executive Officer/Secretary of

the concerned Municipal CommitteeNtmicipal Council/ Municipal Corporation

concerned in case of applicants residing in urban area& It has further been decided

that in case of Haryana Government employees serving in the Offices located at

Chandigarh/Panchkula and residing at Chandigarh/Panchkula, the Resident

certificates and caste certificate to SC/BC employees and for their children , may be

issued by their respective Heads of Departments also.

The validity of Resident Certificate issued by the competent authority

shall be as long as the holder of this certificate maintains his residential address in

Haryana State.

SC certificate once issued shall be valid as long as the caste is

not removed front the Schedule of the Constittattion and BC certificate shall be valid

for life from the date of issue of the certificate or till the applicant does not fall into

creamy layer category as defined from time to time. The applicant applying for BC

certificate would also submit a self declaration on simple paper that he does not fall

under creamy layer category . The format for this declaration is given at Annexure

'A' However, if the certificate has been obtained by fraud or misrepresentation or

concealment of facts or by some other means, the said certificate shall be declared as

invalid /none-st and benefit taken by the applicant will be withdrawn and a criminal

case shall he registered against the applicant misrepresenting the facts as well as

against the guilty officers/officials, if any. In addition, Social Justice &

Empowerment Department, Haryana is being directed to finalize the modelties and

procedure to Constitute the Scrutiny Committee .

The files relating to Caste and Resident certificate shall be

retained for It) years and Register shall be retained permanently . The proformae of

the application form. Register and SC/BC certificates prescribed by the Government

shall be followed by all the Departments/Institutions in letter and spirit as it has come

to the notice of the Govt. that some Departments/Institutions demand such

certificates in proforrnae which are at variance with the profonnae in which these

certificates are being issued by the competent authorities (Tehsildar/Naib

Telisildar/TiODs). it is, therefore, decided that the Departments/Institutions shall

accept these certificates only itt the proformee in which these are being issued by the

competent authorities which have been prescribed by the Govt. itself (copy enclosed)

5 To make institutional arrangements, it has also been decided that in

future the Resident and Caste certificates will be issued to all the students studying in

Class 8th every year as per the time schedule given below

i. filling of application forms by the 1 Nov. to 10th Nov.parents/students every year

ii Verification by (a) Stupanch/ upto 15th NovemberNamberdar. in case of every year

rural areas and Municipal Councillorsin case of Urban areas.

Verification by Fatwari in case of 30th Novemberrural areas/E0/Secy.(1vIC)

any other officer/official authorized bythe local body for the purpose in caseof Urban areas.

Head Teacher/Head Master upto 15th Dec.Forwarding of appliCation to CRO 31'. Dec.by Head Teacher/Head Master ,

iv. Verification & issue of mtificate upto 31'. Januaryby CRC) every year

All application forms of a particular School may be sent to the

Tchsildar/Naib Tehsildar concerned preferably at one go so that the certificates are

issued and sent back to the Head masters of Government Schools/Private Schools

for distribution to the concerned students. The Head Teacher/Head Master shall be

responsible for getting the application forms filled and files prepared of all thestudents of his/her school. As a one time measure, it has been decided that all thestudents presently studying in Class-VIM to NM will be issued these certificates

during the months of January , 2004 to March, 2004. The schedule will be finalizedby the concerned Deputy Commissioner in this regard.

It has been further decided that in case of SC/BC 'students

claiming benefit under various welfare schemes upto Class IX, the benefits will be

given by the Head Master/Head Teacher after getting the verification done from

Sarpanch/Narnberdar/MC and a. caste, certificate issued by the CRO (Tehsildar/Naib

Tehsildar) may not be demanded for this purpose by the School authorities,

The matter 'regarding issue of income certificate to the students for

claiming various benefits in educational institutions has been considered and it has

been decided that in future the income certificate for educational purposes will be

issued by the CRO (Tehsiltiat/Naib Tehsildar concerned) and income certificate for

other purposes by the SDO (C) concerned taking into account income of the applicant

from venous sources including agriculture, trade, profession, salary etc. Theverification will be got done through the subordinate revenue staff in case ofapplicants residing in rural areas and through the Executive Officer/Secretary of the

concerned Municipal Conimittee/Council/Municipal Corporation in case of applicantsresiding in urban areas.9. It has also been brought to the notice of the Government that when

posts are advertised, fairly large number of candidates apply for such posts andHaryana Public Service Commission/Haryana ,Staff Selection Commission/Departments demand attested copies of Resident/Caste certificates and otherdocuments from the candidates. This creates not only financial problems for the

4

unemployed youths but also increases the work load in the offices. Similar is the

position in ease of admission to educational/professional/Engineering institutions To

give relief to the public, it has been decided that at the time-of applying for job or for

admission in educational institutions including technical/professional institutions etc.

self attested photo copy of the certificate about the residence and caste status shall be

sufficient and at the time of final interview/selection, original papers including castes

and Resident certificate issued by the competent authorities may be

obtainedlexamined/inspected by the concerned departments/institutions and attested

copies thereof be kept in record. The fact may also be cross checked/verified at the

time of verification of the antecedents of the applicants before be/she joins the

Government service Similar practice will be followed for degrees/mark sheets/other

certificates of academic qualifications. Necessary action to amend/ revise the

application form in this regard shall be taken by Haryana Public Service

Commission/Haryana Staff Selection Commission/Head of the

DepartmentsfUniversities etc. at their own level under intimation to the Government

These instructions may be brought to the knowledge of all for strict

compliance. .

Yours faithfully,

- Special Secretaryeenerat-Administration,

for Chief Secretary to Government Haryae.

Endst No. 22/28/200 Dated, Chandigarh, the 30 th January, 2004

Copies are forwarded to the Secretary, Ministry of Social Justice &.Empowerment Department, Govt. of India, & Deputy Secretary to Government ofIndia, Ministry of Personnel , Public Grievances and Pension, Department ofPersonnel and Training , New Delhi for in-formation and necessary action.

Special Secretary Genera/Administration,for Chief Secretary to Government Haryana(r4,-

Endst. No. 22/28/2003-3G.S.Ill Dated, Chandigarh, the 30th anuary, 2004

5End. No: 22/28/2003-3G.S.III Dated, Chandigarh, the 30th January,2004

A copy is forwarded to all the Financial Commissioners & PrincipalSecretaries and all the Adniinistrative Secretaries to Govt„ Haryana for informationand necessary action.

Special Secretary/at-half A-dnstratiori,for Chief Secretary to Government Haryana

All the Financial Conimissioners and Principal Secretaries and allAdministrative Secretaries to Government Haryana.

U.Q.N.o 22128/2003-3 G.S. HI Dated, Chandigarh, the 30 th January, 2003.

A copy is forwarded to the Principal Secretary/DPSCM4DPSCM-IliOSD/CM/Private Secretaries to the Chief Minister/Ministers/Ministers of State ofinformation of the Chief Minister/Ministers/Ministers of State, Haryana

Special Secretary Gal Administration,for Chief Secretary to Government Haryana

To

The Principal Secretary/Secretaries/DPSCM-1/DPSCM-11/0SD/CMPrivate Secretaries to Chief MinisterilvlinistersiMinisters of State,Haryana.

U.O.No. 22/28/2003-3 0 S III Dated, Chandigarh, the 30 th January, 2004Endst. No. 22/28/2003-3 G.S. 111 Dated, Chandigarh, the 30th January, 2004

A copy is forwarded to Member Secretary, Haryana Bureau of PublicEnterprises for information and necessary action. They are requested to send the copyof these instructiOns to all the Boartis/Corpomtiorts in the State of Haryana for takingnecessary action.

Special Secretary General Administration,• or Chief Secretary to Government Haryana.

Endst.No. 22/28/2003-30.S.111 Dated, Chandigarh, the 30 th January, 2004.

A copy are forwarded to the following for information and actionwhere• necessary :-

The Director, Local Bodies Haryana for circulating theseinstructions to all the Kt./ Council/Corporations in the State.The Director Public Relation Haryana, Chandigarh for givingappropriate publicity,

Special Secretary GWerarAdministration,for Chief Secretary to Government Haryana

A copy is forwarded to all the Branch Officer/Superintendents/DeputySuperintendents of Haryana Civil Secretariat/E.C. Office for information and

ro

6

necessary action,

reary GnTtMkiüiiistratiofl,for Chief Secretary to Government Haryana

All the Branch Officers/Superintendent/Deputy Superintendents ofHaryana Civil Secretariat/F.C. Office.

U.0,, 22/28/2003-3G.S. III Dated, Chandigarh, the 30 m January, 2004.

From

lo

No. 22/2812003-36,SIII

the Chief Secretary to Government Haryana.

1. All the Heads of Departments in Haryana.

The Commissioners, Rohta,k, Guataon. Hisar and Am alaDivisions.

3. The Registrar, Punjab and Haryana High Court,Chandigarh,

Subject:-

issued.

All the Deputy Commissioners in Haryana.

The Registrars. Maharishi Dayanand University. Rohtak.Kurukshetra University Kurukshetra, Ch. Charm SinghHaryana Agriculture University, Hisar ,Guru JambeshwarUniversity, Hisar & Ch. Devi Lai University Sirso. (Haryana).

Dated, Chandigarh, the 3e January, 2004.

Streamlining the procedure in the offices regarding issuingof Resident /Income Certificates and the caste certificate toScheduled Castes and Backward Classes.

** *

am directed to invite your attention to Haryana Government

26,S.111, dated 03.10.96, No. 22/51/93-30.S.111. dated 12.08.93

14.10.97 on the subject noted above wherein instructions

ertiticates (SC/BC/OBC). and Resident certificates have been

Sire

letters Nos. 62/17t95-

and even No. dated

regarding the caste c

The policy has been reviewed keeping in view the various

courts judgements and the hardships caused to the individuals in obtaining above

juoted certificates. Government is of the view that the procedure be institutionalized

by delegating powers at proper level for ensuring speedy disposal of work without

any harassment or exploitation. Ile present modification of the policy also aims at

simplifying the procedure for obtaining certificate by an individual falling under the

reserved categories:

The matter has also been reconsidered in depth by the State

Government in view of the problems being faced by the Government employees in

obtaining these certificates. With a view to improve the existing system in issuing

various certificates, it has been decided by the Government that henceforth Circle

Revenue Officers (TehsildariNaib Tehsildar<um-Executive Magistrate) concerned

will he authorized to issue Resident as well as Caste Certificates (SC/B('OBC) after

getting the verification done through the subordinate revenue staff in case of

applicants residing in the rural area and through the Executive Ofticer/Secreuuy of

the concerned Municipal ConunitteciMunicipal Council/ Municipal Corporation

concerned in case of applicants residing in urban areas. It has further been decided

that in case of Haryana Government employees serving in the Offices located at

Chandigarh/Panchkula and residing at Chandigarh/Panchkula, the Resident

certificates and caste certificate to SC/BC employees and for their children may be

issued by their respective I leads of Departments also.

The validity of Resident Certificate issued by the competent authority

shall be as long as the holder of this certificate maintains his residential address in

Haryana State.

SC certificate once issued shall be valid as long as the caste is

not removed from the Schedule of the Constituttion and BC certificate shall be valid

for life from the date of issue of the certificate or till the applicant does not fall into

creamy layer category as defined from time to time. The applicant applying for BC

certificate would also submit a self declaration on simple paper that he does not fall

under creamy layer category . The format for this declaration is given at .Annexure

'A' However, if the certificate has been obtained by fraud or misrepresentation or

concealment of facts or by some other means, the said certificate shall be declared as

invalid /none-st and benefit taken by the applicant will be withdrawn and a criminal

case shall he registered against the applicant misrepresenting the facts as well as

against the guilty officers/officials, if any. In addition, Social Justice &

Empowerment Department, Haryana is being directed to finalize the modelties and

procedure to Constitute the Scrutiny Committee ,

The files relating to Caste and Resident certificate shall be

retained for 10 years and Register shall be retained permanently The proformae of

the application form, Register and SC/BC certificates prescribed by the Government

shall be followed by all the Departments/Instirutions in letter and spirit as it has come

to the notice of the Govt. that some Departments/institutions demand such

certificates in proformae which are at variance with th proformae in which these

certificates are being issued by the competent authorities (Tehsildar/Naib

TelisildartHODs). It is, therefore, decided that the Departments/Institutions shall

accept these certificates only in the proformae in which these are being issued by the

competent authorities which have been prescribed by the Govt. itself (copy enclosed)

5 To make institutional arrangements, it has also been decided that in

future the Resident and Caste certificates will be issued to all the students studying in

Class S th every year as per the time schedule given below :-

i. filling of application forms by the V' Nov. to 10 th Nov.parents/students every year

3

Verification by (a) Sarpanchiupto 15 1 NovemberNamberdar. in case of every year

rural areas and Municipal Councillorsin case of Urban areas.

Verification by Patwari in case of 30th Novemberrural areas/E0/Secy (MC)

any other officer/official authorized bythe local body for the purpose in caseof Urban areas.

Head Teacher/Head Master upto 15th Dec.

iii Forwarding of application to CRO 31E, Dee,by Head Teacher/Head Master

iv. Verification & issue of certificate upto 31 E . Januaryby CRO every year

All application forms of a particular School may be sent to the

TehsildariNaib l'chsildar concerned preferably at one go so that the certificates are

issued and sent back to the Head masters of Government Schools/Private Schools

for distribution to the concerned students. The Head Teacher/Head Master shall be

responsible for getting the application forms tilled and tiles prepared of all the

students of his/her school. As a one time measure, it has been decided that all the

students presently studying in Class-VIII to XII will be issued these certificates

during the months of January , 2004 to March, 2004. The schedule will be finalized

by the concerned Deputy Commissioner in this regard,

It has been further decided that in case of SC/BC students

claiming benefit under various welfare schemes upto Class IX, the benefits will be

given by the 1-lead Master/Head Teacher after getting the verification done from

SarpanchiNamberdariMC and a caste certificate issued by the CRC) aehsildar/Naib

Tehsiidar) may not he demanded for this purpose by the School authorities.

The matter regarding issue of income certificate to the students for

claiming various benefits in educational institutions has been considered and it has

been decided that in future the income certificate for educational purposes will be

issued by the CR.0 (Tehsildar/Naib Tehsildar concerned) and income certificate for

other purposes by the SDO (C) concerned taking into account income of the applicant

from various sources includine agriculture. trade. profession, salary etc. The

verification will be got done through the subordinate revenue staff in case of

applicants residing in rural areas and through the Executive Officer/Secretary of the

concerned Municipal Committee/Council/Municipal Corporation in case of applicants

residing in urban areas.

Ii has also been brought to the notice of the Government that when

posts arc advertised, fairly large number of candidates apply for such posts and

Haryana Public Service Commission/Haryana Staff Selection Commission

/Departments demand attested copies of Resident/Caste certificates and other

documents from the candidates. This creates not only financial problems t'or the

4

unemployed youths but also increases the work load in the offices. Similar is the

position in case of admission to educational/professional/Engineering institutions To

give relief to the public, it has been decided that at the time of applying for job or for

admission in educational institutions including technical/professional institutions etc.

self attested photo copy of the certificate about the residence and caste status shall be

sufficient and at the time of final interview/selection, original papers including castes

and Resident certificate issued by the competent authorities may be

obtained/examinedlinspected by the concerned departments/institutions and attested

copies thereof be kept in record. The fact may alsri he cross checked/verified at the

time of verification of the antecedents of the applicants before he/she joins the

Government service. Similar practice will be followed for degrees/mark sheets/other

certificates of academic qualifications. Necessary action to amend/ revise the

application form in this regard shall be taken by Haryana Public Service

Commi ssioull laryaria Staff Selection Commission/Head of the

Departments/Universities etc. at their own level under intimation to the Government.

These instructions may be brought to the knowledge of all for strict

compliance,

Yours faithfully,

En .st. No. 22/28/2003-30.S.11

Special SecretarreeneratAtrifinfmation,for Chief Secretary to Government Haryana.

• 11,

Dated, Chandigarh, the 30th January, 2004

Copies arc forwarded to the Secretary, Ministry of Social Justice 8z,Empowerment Department, Govt. of India, & Deputy Secretary to Government ofIndia, Ministry of Personnel Public Grievances and Pension, Department ofPersonnel and Training , New Delhi for information and necessary action.

- -Special Secretary General Administration,

for Chief Secretary to Government Haryana

Endst. No. 22/28/2003-3G.S.III Dated, Chandigarh, the 30th artuary, 2004

5

Endst. No. 22/28 12003-3G.S.111 Dated, Chandigarh, the 30th Jarmary,2004

A copy is forwarded to all the Financial Commissioners & PrincipalSecretaries and all the Administrative Secretaries to Govt. Haryana for informationand necessary action.

Special Secretaryradiefiil'Adniinistration,for Chief Secretary to Government IIaryana

ToAll the Financial Commissioners and Principal Secretaries and allAdministrative Secretaries to Government Haryana.

U.O.No. 22/28/2003-3 G.S. ill Dated, Chandigarh, the 30 th January, 2003.

A copy is forwarded to the Principal Secretary/DPSCM-I/DPSCM-IDOSD/CM/Private Secretaries to the Chief Minister/Ministers/Ministers of State ofinformation of the Chief Minister/Ministers/Ministers of State, Haryana

- -Special Secretary Gaeral Administration.

for Chief Secretary to Government Haryanafl--

ToThe Principal Secretary/Secretaries/DPSCM-1/DPSCM-11/0SD/CMPrivate Secretaries to Chief Minister/Ministers/Ministers of State,Haryana.

U.O.No. 22/28S2003-3 G.S. Ill Dated. Chandigarh, the 30 th January, 2004Endst. No. 22/28/2003-3 G.S. Iii Dated, Chandigarh, the 30 th January, 2004

A copy is forwarded to Member Secretary, Haryana Bureau of PublicEnterprises for information and necessary action. They are requested to send the copyof these instructions to all the Boards/Corporations in the State of Haryana for takingnecessary action.

Special Secretary neneral Admiaistration,for Chid Secretary to Government Haryana

V--

Endst.No, 22/28/2003-3G.S111 Dated, Chandigarh, the 30th January. 2004.

A copy are forwarded to the following for information and actionwhere necessary :-

1. The Director, Local Bodies Haryana for circulating theseinstructions to all the M.C./ Council/Corporations in the State.The Director Public Relation Haryana. Chandigarh for mvi ngi

appropriate publicity.

- -------'Special Secretary G-eleral Administration,

for Chief Secretary to Government Haryana

A copy is forwarded to all the Branch Officer/Superintendents/DeputySuperintendents of Haryana Civil Secretariat/F.C. Office for information and

6

necessary action.

4ecial ietary Genziat-Mministration,for Chief Secretary to Government Haryana

All the Branch Officers/Superintendent/Deputy Superintendents ofHaryana Civil Secretariat/F.C. Office,

U.O.No. 22/28/2003-30.S. Iii Dated.. Chandiorh, the 30 th January , "004.

o'N

22 / 28 / 2003-31[Ci-T.Til

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17

AFFIDAVIT OF THE PARENT/GUARDIAN TO BE ATTESTED BY

EXECUTIVE MAGISTRATE /OATH COMMISSIONER/NOTARY PUBLIC

----- ---------father/mother/guardian -------------ofMiss/Mr. resident of------------do hereby solemnly State andaffirm as under:-

1. That I am a citizen of India

That neither the deponen: nor the Child/ward of the deponenthave obtained the benefit of Residence in any other State

Dated DEPONENT

VERIFICATION

Verified that the contents of my above affidavit are true and correct to thebest of my knowledge and belief and nothing has been concealed therefrom.

Dated DEPONENT

RE,IDENCE CERTIFICATE TO BE ISSUED BY THE PRINCIPAL(HEADM4STERS OF THE GOVERNMENT/ RECOGNIZED SCHOOL/

COLLEGE.

It is certified that Dio Sh.------- ---has been a student of this School/College for a period of ---------------Year, from--

to-------------- -- He left the school/college on---------------

Dated Signature of Principal/Headmaster ofthe school/College (with seal )

RESIDENCE CERTIFICATE TO BE ISSUED BY D OF DEPARTMENT

Certified that Sh. S/o S

N of Missr. is an employee of theof Haryana Government. He is working asHe has more than three years service at his credit.

Place: He d of the Department

Dated (with seal)

father(Name ofoffice)

and is posted at

RESIDENCE CERTIFICATE TO BE ISSUED BY THE RESPECTIVE HEAD OFTHE DEPARTMENT IN THE CASE OF THE EMPLOYEES OF GOVERNMENTOF INDL4.

Certified that Sh. Sio Sh. father of Miss/Mr. is an employee of Government of India working as Hehas been posted at Chandigarh' Haryana in connection with the affairs of HaryanaGovernment for the past three years.

Dated: Head of Department(with seal)

RESIDENCE CERTIFICATE TO BE ISSUED BY THE DEPUTYCOMMISSIONER, SUB DIVISIOIVAL OFFICER (CIPIL), G.A. TO D.C. D.R.Q.EM AND TEHSILDAR.

Certified that Sh. St() Sh.father/guardian of Miss/ Mr. hold (name of Child/ward with fulladdress) immovable property at place and District ) in the State ofHaryana for the past years.

OR

Certified that Miss/NIL Sits Sh. residentof was born in Haryana as per birth -ertificate.

Dated: Signature of the Authority(mentioned above)

with seal)

The validity of Resident Certificate shall be as long as the holderof this certificate maintains his residential address in Haryana State.

V

PERFORMA OF

of Datecertificate

REGISTER TO BE MAINTAINED BY THE ISSUING AUTHORITY (rEtisium R/NAIR TEHSILDAR)

Name of the Applicant ee. Verification done by Name 1 Signature of issuing

Address SarpanchThiambardar i Patwari Headmaster I Authority

issued,

i

K7146 C' S. .44.6.1". . M.