Form Of Caste Certificate To Be Produced By Other Backward Classes Applying For Appointment To Posts Under The Government Of India Page 2

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Form of declaration to be submitted by OBC Candidate
(in addition to the community certificate)
I,________________________son/daughter
of
Shri____________________resident
of
village/town/city_____________________district________________state________________
hereby declare that I belong to the __________________________community which is recognized
as a backward class by the Department of Personnel and Training Office memorandum No.
36012/22/93-Estt. (SCT) dated 08.09.1993. It is also declared that as on closing date I do not belong
to persons/sections (Creamy layer) mentioned in column 3 of the Schedule to the above referred
memorandum dated 08.09.1993.
Signature of the candidate:.............................................................
Full Name:.............................................................
Place:...............................................................
Date:..............................................................
Declaration/undertaking not signed by Candidate will be rejected

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