Applicant's Details :
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Applicant's Name : *
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First Name
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Middle Name
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Last Name
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Residential Address : *
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Pin code :
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Mobile :
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Occupation :
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Family Business :
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Applicant's Father's Details :
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Father's Name :
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First Name
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Middle Name
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Last Name
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Father's Residential Address :
(If not alive, his last address)
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Pin
code :
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Father's occupation :
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Father's family Business :
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General Family Details :
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Caste name : *
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Mother tounge :
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Primarily spoken language :
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Person's details seeking caste certificate :
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Name : *
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First Name
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Middle Name
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Last Name
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Father's/husband's Name : *
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First Name
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Middle Name
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Last Name
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Name & Address of village/town/city
where family ordinarily resides :
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Presently residing city :
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Pin code :
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Ward:
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Native place :
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Reason for leaving home village/town/city :
(Eg. for Education, Service, etc)
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School's name and address :
(Attach Leaving / Bonafide Certificate
as applicable)
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Caste name in school leaving Certificate :
(Attach samaaj Certificate)
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Father's details of person seeking caste certificate :
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Father's Name :
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First Name
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Middle Name
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Last Name
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School's name :
(Attach Leaving Certificate as applicable)
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Caste name in school leaving Certificate :
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If working, caste name provided in
the company (company should be
registered under mumbai area) :
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Residential proof :
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Birth/Death certificate proof :
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Other proof :
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If father does not have the caste certificate then other elderly person's caste
certificate details :
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Name of that Person :
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First Name
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Middle Name
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Last Name
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Relation :
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Details of proof :
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Caste name in the proof :
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Have you ever applied for
caste certificate earlier :
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If yes, name of competent authority
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Reason for requirement of caste certificate :
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Any other comment :
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Please bring following document proofs:
- School leaving certificate / Bonafide Certificate. caste must be mentiioned
- Voter ID Card.
- School leaving Certificate of Parent or Guardian -(e.g.
Father, Uncle, Brother, Grand Father, Father's Sister, Cousin Brother, Cousin Uncle,
Cousin Grandfather or Great Grandfather) or Village Form No. 14
- Affidavit in Prescribed Format
a) All submitted documents with their details should be mentioned in Affidavit.
b) Any mistake in Name/Surname should be mentioned in detail with reasons in Affidavit.
c) If Caste proof is of Grand Father/Great Grand Father/Cousin Uncle/Cousin Brother/Cousin
Grand Father, etc. then Family Tree should be mentioned in Affidavit.
- Caste Certificate of Parents i.e. Father/Grandfather/Aunty
(Father's Sister)/Uncle (Blood Relation). Please Note that the Caste Certificate
should have been issued by Competent Authority or Caste Validity Certificate issued
by Caste Scrutiny Committee/ Village No.14, Service Book relevant page extract copy
where caste is mentioned.
- Residential proof for SC-
10-08-1950, for VJ/NT-21-11-1961 & for OBC & SBC- 21-10-1967
- Community Certificate (Samaj Certificate)
- Government Gazette Copy required if there is a change
in name.
- For Married Women, Government Gazette, Change Name Copy
or Marriage Certificate is required.
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