Government of ………………………..
(Name & Address of the authority issuing the certificate
INCOME & ASSET CERTIFICATE TO BE PRODUCED BY ECONOMICALLY WEAKER SECTIONS
Certificate No. …………
Date : …………
VALID FOR THE YEAR …………
This is to certify that Shri/Smt./Kumari ………….. son/daughter/wife of …………….. permanent resident of
……………………….. ViIlage/Street ……………………….. Post Office………. District……… in the State/Union Territory
…………………… Pin Code …………. whose photograph is attested below belongs to Economically Weaker Sections, since the
gross annual income* of his/her family** is below Rs. 8 lakh (Rupees Eight Lakh only) for the financial year His/her family does
not own or possess any of the following assets*** :
I. 5 acres of agricultural land and above;
II. Residential flat of 1000 sq. ft. and above;
III. Residential plot of 100 sq. yards and above in notified municipalities;
IV. Residential plot of 200 sq. yards and above in. areas other than the notified municipalities
2. Shri/Smt./Kumari …………… belongs to the …………… caste which is not recognized as a
Scheduled Caste, Scheduled Tribe and Other Backward Classes (Central List)
Signature with seal of Office …………
Name …………
Designation …………
.
Recent Passport size
attested photograph
of the applicant
*Note 1 : Income covered all sources i.e. salary, agriculture, business, profession, etc.
**Note 2 :The term 'Family" for this purpose include the person, who seeks benefit of reservation, his/her parents and siblings below
the age of 18 years as also his/her spouse and children below the age of 18 years.
***Note 3 : The property held by a "Family' in different locations or different places/cities have been clubbed while applying the land
or property holding test to determine EWS status.
NOTE :-
The Income and Asset Certificate issued 'by anyone of the following authorities in the prescribed format as given above
shall only be accepted as proof of candidate's claim as 'belonging to EWS : -
(i) District Magistrate/Additional District Magistrate/ Collector/ Deputy Commissioner/Additional Deputy
Commissioner/1st Class Stipendiary Magistrate/ Sub-Divisional Magistrate/ Taluka Magistrate/ Executive Magistrate/
Extra Assistant Commissioner,
(ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/ Presidency Magistrate,
(iii)Revenue Officer not below the rank of Tehsildar and
(iv) Sub-Divisional Officer or the area where the candidate and/or his family normally resides.
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