GCP- 37•-7-13,35,000 Cps ~ay-2 10 (H,-4)

Dated .. ) .h(~· .. 20 Q...,

WrTQJL..L& ~tf)d@ '1ff/lT : ~
District Code : o,1,.... 5
6rrwf;t>{p n • : QJL..L& ~tfjd@
Taluk Code
n• I
0
1 2I
Certificate No. :

10252531 iJurrw& ~{,11@ n •

Village Code :I0 I2 I 1 ,

'1l@;u4a: ~[Link]~!P
. ~OMMUNITY CERTIFICATE
[6rTlD556l) . . ~ '""'.-s l"\ If: ni. •19 - -Iii . .
Jj~:Wii:~~~~:_,...~~;:
_ _ __ ___£>, -
%~;;;;··J
- ...
Q~;;ID
-
·~7=~'!Z'.;"~.:; ~~L.JLJRTTTirl5ftlTQJfr Qµ,uir
- • u ' J ~ ~ir.
Jl!J& octi~ ~ nA11 28, t.5Jfl)LJL..L W!CWJW LJ9<Ml/UJ u1fDUL..L ul(fl&ior
t,truj, 4,Jffli), fjlTfW 19-7-1994 ilJlfiA>6' n•········· ~\.......u1.9- ,.jj,LJL..L t!lrf1~6
~rrrtH,Q1tr nffl6 ~w
tr)Qfluuu@iJ!Qlil.
This is to certify that.. ..............................................................Son / Daughter of
Thiru ................. ....................................of............................................................
Village/ Town .............. ,............................. Taluk ............................................. .
District of the State of Tamil Nadu belongs to ... ... ... ...... ... ..... .. ... .
. . . . . .. . . . . . . . . . . . . . . . 1 . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .. Community, which
is recognised as a
Backward Class as per Government Order (Ms.) No. 28, Backward Classes
and Most Backward Classes Welfare, dated 19th July 199~
vide Serial No.......... .......... .
2. iJ<!§ / i)(!§wi) /
G"ad- ~~ ___,==,,,. Q6"'QJ" /
nwu~~ ~QJ~ ,µ ~ IP~ · '-9-"' ~@Lilu~ w~
LDfTQJLL.#)6\J ,szl®,:~ m,~c q I ~ j iU..,;;,+~~ -~.-r.....a. -.....-,
i>urrw;,,)6iJ / !J&Ujj6U QJFf/dJ '11~g:,rrfr&fU nAT6 iFTTRTfDdl&&uu@li)!WJJ.
2. It is certified that Thiru/Tmt./Selvan/Selvl.. ................... ........................ and
h i ~ ~ly reside(s) at .....................................................Village/Town
~~\-f.:-1'd:.....l&~ ........ Taluk .... . ... ... .... .... ..... .. ...... .... .. . District of
~ ~\
~
~r.-- 1~ '-' \
Se ·'
adu~, ·,~
rr , ,.:
' · "~
.. 'lf
J'

"
q)

~
~
m&Gurruuw
Signature
~
~
~ 1/r.
I '1 :a
r.:
•
: (\ r :(~
, Jt \ r-. ~ ~
~ ~

t~. ('., ,,.fl

\ f~ • •
' ' 11 ' (
(✓ !I "' ~ fT SD9•• " ~ ~&&•"''°' . \. \()
\ • r"' i.t1 .-i ~ ~ . ame (in Capital ~16Jl!tilOUJL~, ~ l»«tT eJl'..LITt~l1li
"'- . } I • .. ;f u~ : \
~ U(Zl)~; !. Designation .()®tl'1arruQ&n(B.
--