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Form B-2 (Amended)

RULE 5(5)(4)(IV)
Form of Caste Cerfiticate to be issued Other Backward Classes, Vimukta Jati(A) Nomadic
Tribes(B, C & D) and Special Backward Class and its synonyms belong to State of Maharashtra
Documents
Verified

(1)

(2)

(3)

(4)

CASTE CERTIFICATE(Part-A)
SDO/Dy.Col/O.B.C./V.J.N.T./S.B.C./Regi/Case No._______________________/Year__________/
Outard No.________Dated___________
This is to certify that Shri/Shrimati/Kumari____________________________________________
son/daughter____________________ of village/town __________a District/ Division__________of the
State of Maharashtra belongs to the_____________Caste /Community which is recognised as a Other
Backward Class/Denotified Caste (Vimukta Jati) Nomadic Tribes(B), (C) & (D) and Special Backward
Class under the Government Resolution No._____________________________________________
dated_________________as amended from time to time..
2.
Shri/Shrimati/Kumari_________________________and/or/ his/her family ordinarily
resides(s)inVillage/Town___________________of_______District/Division
of the State of Maharashtra.
NON CREAMY LAYAER CERTIFICATE (PART-B)
3.
This is to certify that Shri/Shrimati/Kumari_______________________does not belong to the
persons/sections (Creamy Layer) mentioned in the Government of Maharashtra Gazette, Part IV-B, dated
29th January, 2004, Maharashtra State Pulbic Service (Reservation for S.C./S.T./D.T.(V.J.)N.T.,S.B.C. &
O.B.C. Act, 2001 and instructions and guidelines laid down in the Government Resolution, Social Justice,
Cultural Affairs, Sports and Special Assistance Department No.CBC-10/2001/Pra.Kra.120/Mavak-5, dated
1st November 2001, CBC-1094/Pra.Kra.86/Mavak-5, dated 16th June, 1994, CBC-1094/Pra.Kra.86/
Mavak-5, dated 5th June, 1997 and Government Resolution No. CBC-10/2001/Pra.Kra.111/Mavak-5, dated
29th May, 2003.
4.

This Certificate is valid for the period of _________________year from the date of issue.

Watermark
Hologram
Signature : ..........................................
Designation : ..........................................
(With Seal of Office)
Place : _____________
Dated :______________.
Please delete the words which ae not applicable
# Please quote name of department and specific number and date of Resolution under which the caste/tribe has been
recognised as OBC, VJNT, SBC by the Government of Maharashtra.
Note:-The term Ordinarily reside(s) used here will have the same meaning as in Section 20 of the
Representation of the Peoples Act, 1950.

PAGE -2 (Part - B)
Renewal:5.

This Certificate is further extended for the period of _________________year.

Signature : ..........................................
Designation : ..........................................
(With Seal of Office)
Place : _____________
Dated :______________.
6.

This Certificate is further extended for the period of _________________year.

Signature : ..........................................
Designation : ..........................................
(With Seal of Office)
Place : _____________
Dated :______________.

7.

This Certificate is further extended for the period of _________________year.

Signature : ..........................................
Designation : ..........................................
(With Seal of Office)
Place : _____________
Dated :______________.
8. .

This Certificate is further extended for the period of _________________year.

Signature : ..........................................
Designation : ..........................................
(With Seal of Office)
Place : _____________
Dated :______________.


(Creamy-layer)

.........

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