GOVERNMENT OF KARNATAKA
REVENUE DEPARTMENT
FORM-F
Office of Tahsildar,
BALLARI Taluk,
Date: 30/10/2024
INCOME AND CASTE CERTIFICATE
Certificate No: RD1218181148945 * RD1218181148945*
This is to certify that Smt. SHAMEEM W/O Sri. JAFAR(Husband Name) and D/O Smt. MALIKA (Mother
Name) residing at House No 57 ward No 27, Hatti Makhan Street Cowl Bazar, Bellary , 583102 of Ballari ( Ward
No 27 ) Village/Ward, Ballari Hobli, BALLARI Taluk, BALLARI District and his/her family does not come within the
purview of creamy layer specified in Government Order No.:Himvaka 304 BCA 2017; Dt: 14.09.2018.
Either the applicant or his/her/parents/guardian/wife/husband is not class-I or class-II officer in the service of the Government;
OR
Does not hold an equivalent post in Public Sector Undertaking;
OR
Is not an employee under a Private Employer and drawing a salary which is not less than that of a Class-II Officer (initial stage of
the pay scale of Rs.22800-43200/-)
OR
His/Her Father, Mother/Guardians Gross Annual Income does not exceed Rs.8.00 lakhs (Rs. Eight Lakhs)
OR
His/her parents/Guardian/husband/wife is not holding 10 units of Agricultural land or such of those not holding more than 20 acres
of plantation land as specified in the Karnataka Land Reforms Act 1961.
Certified that Smt. SHAMEEM W/O Sri. JAFAR residing at House No 57 ward No 27, Hatti Makhan
Street Cowl Bazar, Bellary , 583102 of Ballari ( ) Village/Ward, Ballari Hobli, BALLARI Taluk, BALLARI
District belongs to caste Muslim of Category I I (B) of the Backward Classes and certified that his/her family annual
income is Rs. 40000 /- ( Rs. forty thousand only. ).
This certificate is valid for fiveyear.
Date: 30/10/2024
Note : This is a digitally signed certificate and does not require manual
signature.
Please, verify authenticity of this certificate by visiting
www.nadakacheri.karnataka.gov.in & entering certificate Number.
Name: JUGALA MANJUNAYAKA
Tahsildar
BALLARI Taluk
BALLARI District