SCiST Certificate
Page I of 1
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GOVERNMENT OF KART{ATAKA
REVENUE DEPARTMENT
FOIIM-D
Schedule Casle/Scheduled l'ribes Certilicate
This is to certill that Sri. MOHAN S1o Sri" C.BHARATH is a resident of RAGHAVA KALYANI
COLONY, BHATHRI ROAD VIDYA NAGAR, BELLARY, in Bellary(Ward No 3t
)Ward, tsegary
Taluk, Bellary Flobli, Bellarv Distlict, in the state of l(arnataka belongs to the Caste / Tribe*
Schedule Caste
(Adi Dravida) which is recognized as Schedure casle/Scheclule Tribe under :-.
* The Constitution (Scheduled Castes) Order, 1950
x The Constitution (Scheduled
Tribes) Order, 1950
Sri' MOHAN Sio Sri. C.BHARATII and / or family ordinarily reside (s) in Bellary (Ward No 3l)Ward of
Bellary District of the State of Kar-natal<a.
This cerlificate is valid for lif-e time
Datezl3/02/2014 Tahsildar
Bellary Taluk,
Bellary District
NOTE:This is a digitally signed +
d gnature.
Acknowledgement No:RD003 8 I 8 I I 0393.) i
Ver:3.1
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The Certilicate can be Verified at rr r, ir
http. I I 10.1 0.i 0. 1 27NK/WebForms/Commonprintpagr:.aspx
14-02-2014