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~~ ............... . ~ ····························· SOCIAL CASTE CERTIFICATE (MIGRANT) fhis is to Certify that Shri/Shrimati/Kumari --------------------------------· -------·-Son/Daughter :Jf ------- -------- ----------------------··- of Vi ilage/T ovv'n ------------··--------··--------------in-••----------- ---------------:---------District/Divi sion ------------------· ------- ------------of the State/Uni on T er itory ---- - _________________ .: ____ belongs tn the -----------------------------Caste/Tribe wihch is r('.cogniscd ns a Schi:.duled Caste/Scheduied 1 ·nbe Under :-
1._ The Constitution (Scheduled Castes) Order, 1950
2. The Constitution (Scheduled Tribes) Order, 1950
3. The Constitution (Scheduled Castes)(Unior, Teritories) Order, 1950
4. The Constitution (Scheduled Castes)(Union Teritories) Order, 1951 As amended by the · Sche<luled Castes and Scheduled Tribes Lists (Modification) Order, 1956 the Bombay Reorganisation Act, 1960 the Punjab Reorganisation Ac:.. 1966, the State- of Himach<1l Pradesh Act, 1970, the North Eastem Areas (Reorganisation) Act, 1971 and the Scheduled Cast.es arid Scheduled Tribes orders (Amendment) ,'\~t, 1976.
5. The Constitution (Jammu and Kashmir) Scheduled Castes Order. 1956
6. The Constitution (Andman and Nicobar Islands) Scheduled Tribes Order, J 959 as amended by Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976 ·
7. The Cc::istitution (Dadra and Nagar Haveli) Scheduled Castes Order, 1962
8. The Constitution (Dadra and Nagar Haveli) Scheduled Tribes Order, 1962
9. The (\m.~titution (Pondichery) Scheduled Castes Order, i 964 l !J. TJ~e Constituti:1n Scheduled Tribes (Uttar Pradesh) Order, 1967 l l. The Con~titution (Goa, Daman And Diu) Scheduled Castes Order, J 968 ·
12. The Constitution (Nagaland) Scheduled Tribes Order, 1970
13. The Constitution (Sikkim) Scheduled Castes Order, 1978
15. The Constitution (Sikkim) Scheduled Tribes Order, 1978 "'This Certificate is issued on the basis of the Scheduled Cast't"s/ Scheduled Tribe Certificaie issued lo ShiiiShrimati/Kumari ----------------------------------------So.n/Daughter of--·-------·------------ --------·---------------- of ViHageff oi\11 ---------------------------------··· ir. .. ---------. ------------------------ District/Division ______ ..; ____ '-----------------------------of the State/Union Teritory -------------------:------- who belong ~o the •·-----------------------Caste/Tribe wihch is recognised as a Scheduled Caste/Scheduled Tribe in the State/Uriion Teritory --------------------------------issued by the------------ ✓ ----------------{_name of prescribed authority) vide their no ................ : ..... .dated .......... : ......... and the holder on the certificate is not entitled to any concession/ facilities extended to Scheduled Caste/ Scheduled Tribes by the Government of Chhattisgarh. · -** Shri/Shrimati/Kumari -------------------------- and or his/her family ordinary reside(s) om village/ town ---------------------- of ----------~~------------- District/ Division of the State of Chhattisgarh.
* Appiicablc to Migrants only **Not applicable to 1vfigrants Signature .. ' Designation (With seal of Offic~r) ,.
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New Raipur, the 2nd September 2013 NOTIFICATION No. F 13-23/2012/R.C./l-3.-In exercise of powers conferred by Section 19 of the Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013 ( (No. 13 of 2013), the State Government, hereby makes the following Rules, namely: - RULES
CHAPTER-I PRELIMINARY
1. Short Title and Commencement.• (l)These rules shall be called the Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Rules,
2013.
(2) These rules shall come into force from the date of their publication in the Official Gazette . .
2. Definitions.- (1) In these rules, unless the context otherwise requires,-
(a) "Act" means the Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013 (No. 13 of 2013);
. (b) "Applicant" means a person, applying for Certificate in prescribed manner, verification of Certificate,· a person whose Certificate is to be verified as decided by the District Level Certificates Verification Committee, or a person whose employer, educational institution, local authority, the Central Government or the State Government, as the case may be, has referred his Certificate to the District Level Certificate Verification Committee for verification;
(c) "Application'' means an application under these rules;
(d) "Certificate" means a Social Status Certificate as defined under clause (o) of Section 2 and
(e) "Date of Presidential Notification" means with reference · Scheduled Castes notification dated 10th of August, 1950 and with reference to Scheduled Tritv~ ·orif,~ .ttion dated 6th of September, 1950;
~f) "Migrants from other States" means the person migrating ir 1e geographical area of State of Chhattisgarh from other State or Union Territory after the Date of Presidential Notification or Notification Date of Other Backward Class or who has been born after the Date of Presidential Notification or the Notification Date relating to Other Backward Class, as the case may be:
·Provided that his father or legal guardian must have migrated into the geographical area of State of Chhattisgarh· after the Date of Presidential Notification or Notification Date relating to Other Backward Class, as the case may be;
(g) "Non~ Applicant" means the employer or educational institution or local authority, the_ State Government or the Central. Government, as Jhe case maybe, which has referred the Ce1tificate of Applicant to the verification committee fw.verification;
' . , .
(h) "Notification Date of Otlier- Backward Classes" means 26th of Decemb~r, 1984;
(i) "Notification of State Government regarding Other Backwi;;d Class" means the order issued by the Governor or notified list of Other Backward Classes, in connection with State of Chh:~tisgarh, as amended from time to time;
(i) "Prescribed" means prescribed under these rules;
(k) "Presidential Notification" means ~rder issued by the President under Atticle 341 and Article 342 of tt,.e Constitution of India with respeci to thy State of Chhattisgarh, .and as amended by the I Parliament from time to time;
• t . (l) "Provisional Social Status Certificate" means a Social Status Certificate issued in Form 4R under Rule 1 O;
(m) "Relative" means related by blood from the side of applicant's paternal family;
(n) "Resolution of the Gram Sabha" means any declaration, conclusion, decision or a resolution of Gram Sabha of the village where applicant is domiciled, in connection to the social status of the applical?t, so as to clear the social status of the applicant unambiguously;
(o) "Scrutiny C(;immittee " means High Power Certification Scrutiny Committee constituted under sub-section (I) of Section 7 of the Act for scrutiny of Certificate;
(p) "Verification Certificate" means the certificate, issuecl by the District Level Certificates Verification Cp..mmiU~t};.;va-1idllU.Ug;Jh~Certificate issued by the CompetentAuthority;
788 (47) ( q) · "Verificatimi Committee• means District Level Certificates Verification Committee constituted· •· ·, · in a District under sub-section { l) of Section 6 of the Act for verification of Certificate issued to applicants.
/
(2) Words and Expression not defined ia these rules shall have the same meanings as defined unde.- the Act.
CHAPTER-I!
ISSUING OF SOCIAL STATUS CERTIFICATE J. Application for issuance of Certificate.• (1) The applicant in order to obtain Ce1tificate on permanent basis. shaU submit mi application to the Cmi1petent Authority in Form• lA .
. (2) Applicant shall submit his application to the Competent Authority in person or through post or Choice Centre or a Common Service Centre .
. (3) Applicant shali submit along wW1 application following documents, namely:
(a) An Affidavit in Form-:-2A, in original;
(b) Family tree of the applicant sta1ting from last three generations, duly issued by the HaJka Patwari:
(c)·Document or t{e!f atttsted copy of the docwnent verifying that his ancestors were residing in the geographical limits of the State of Chhattisgarh on or before tie Date of Presidential Notification or Notification Date relating to Other Backward Class, as the case may be;
(d) In cases where applicant is an officer/employee allocated to Chhattisgarh State Cadre or their children, in compliance, ~f Section 67 of Madhya Pradesh Reorganisation Act, 2000 (No.28 of 2000), principles laid down in Para ( 1) and (2) of the Notification dated 23/09/2007of State Reorganization Cell. Such document or duly attested copies of documePts, verifyir,g tbat- 0) ancesmrs of the applicant were resid~ng in the geographical limiu of the then State of Madhya Pradesh_ before or on the Date of ~sidential Notification OI" Notmcat:on Cate ;elating to Other Backward Classes. as the case may be;
(ii) they have be~r: aHotted to Chhattisgarh State Cadre under Section 67 of the Madhya Pradesh Reorganisation Act. 2000 (No.28 of 2000).
(e) Any r:: th;? following document or self attested copy showing caste of the applicant's father or r.nc~tor, namely:- (!) Revenue document of ancestors (case file);
' (II) fama-Bandi (Survey) or Girdawari;
(rn) Stat~ Se:tbment;
(IV) Document of Rights (1954);
(V) Census ( 1931 )~ (VI) Survey of Forest Department;
(VII) National Register of Citizens ( 1949);
(VIII) Register of Birth or Death;
(IX) Admission Register (Dakhil/Karij), in case father or ancestors were literate;
(X) Caste Certificate. issued earlier to Father, Ancestor or a relative;
(XI) Resolution passed by the Gram~Sabha regarding caste of the applicant where no documentary evidence in proof of caste is available;
(f) Income certificate of preceding year of applicant's father in case of Other Backward Class Applicant;
(g) Envelope having appropriate postage stamp and legible address.
(4) The applicant shall submit original certificates and documents, at the time of verificatio~ or whenever required, before the Competent Authority, District Level Certificate Verification Committee or Scrutiny Committee, as the case may be.
4. Registration of Appi.ication.- The Competent Authority on receipt of the application shaH register the application in a register, prescribed in Form SA
5. Preliminary Inquiry of the Application, Receipt and Return Memo.- (1) After registering application, the Competent Authority shall make a preliminary inquiry summarily, to ascertain whether the application is complete or not and whether document required under sub-rule (3) of Rule ', 3 are annexed or not. In case, the Competent Authority finds that the required document is annexed with the application, he shall, make available to the Applicant receipt prescrib~d in Form-3A and in . ' case required documents are not annexed shalJ gi'-'e to the Applicant a Return Memo in Form-3B within 7 days of the receipt of application.
(2) Countetfoil of the Receipt or Return Memo, as the case may be, shall be kept in the office of Competent Authority.
6. Inability Memo.- (1) An applicant belonging to Scheduled Castes 9r Scheduled Tribes, who has applied for obtaining Certificate, inspite of adequate efforts could not get the required document under sub-rule (3) of Rule 3, may give an affidavit about his inability to submit such document in prescribed Form-3C, printed on the back of Return Memo.
(2) On receipt of Inability Memo, the Competent Authority shall not demand for the required document or documents under sub-rule(3) of Rule 3 and shall proceed to inquire the claim of the appli_cant under Rule 8:
Provided that the applicant shaU present himself during such inquiry before the .. Competent_ Authority or before the inquiry pfficer indicated by him and shall give all necessary / . (..,., ff~ • f i; i . " 0 assistance to ensure the presence of ielated persons, so as to prove his claim of social status.
7. Inquiry Officer.•. Com pet en~ Officer, within: fifteen day5 from the date of receipt of such application shall either proceed to inquire himself or shall direct a subordinate Revenue Officer for Inquiry.
8 Inquiry~- (1) The InquirJ Officer, shall inquire about the residence, permanent address, revenue records, immovable property, occupation of applicant's family. name in voter list and other evidence. which am relevant to prove the permanent residence on the Date of Presidential Notification o::- Notific::ition D:ne relating to Other Backward Oasses, as the case may be, and shall verify the sociat statu., claimed by the Applicant.
(2) Tbe Competent Authority may. apart from documents mentioned in sub.rule (3) of Rule '.::>, inquire into documents of local bodies. for exa~p}e, of Gram Panchayal. Janpad Panchaynt, Zila Panchayat. Nagar Panchayat, Munidpalit)' and Munici.p::d Corporation also.
(3) Inqu!ry officer may ,tfiio :re.::urci oral statements. as t;vide-nce. of viUage Kotwar, village Sarpanch, . 1 Halka Patwari, local ward member, other public representatives -of the area, gazened officers residing in the focali~y, other !ocaJ m~mbers of thai caste already h:;.v;ng Certific.1te and. knnwing the applicant properly.
(4) Inquiry offker. where he i~ not a Competent Officer, attcr inquiry shall furnish his v.•rilter. P..cport · havmg dear outcome., along with c!~cumentary evidence artd reccrd~d oral ~tate1mmls {o the Competent Authcrity, withic fiftecu o:iys of receiving inquiry orden;
9 Sociel Status Certitleute~ The Competen( Authority after receiving application under sub-ruk (J) of Rule 3 and comim:-~fag an i11guiry under Rule 8 and in case where himself is. not an inquiry officer, after satisfying hin1:;elf with the annexed documents and Repmt of the inquiry officer, within one.
month from the date of receipt of application1 shaH is£ue the certificate in F'orm-4A(l J to the Applicam of Scheduled Castes, in Form- 4A(2) to the ~pp}i.._.ant of Scheduled Tribes and in Form- 4A(3) to the app!icant of Other Backward Classes.
JO Provisional Certificate- {1) For the purpose of granting admission to educational institutions upto tenth standard or for gram~ng ~cho!arship or stipend at s~ch Jcvd or for sucb other purposes, where large numbers of Certificates are necessary and it is not feasible to issue such Cenjficate weH i11 time, the Compet~nt Authority, may issue a provisional certificate in Form-4ll on the basEs of affidavit given hy th,;: appiicam: iri Form~2A within fift~en days from tht' date of appfkation:
Provided that the Competent Authority shall mai.."Ita.in the derails ol prC'vhionai ccrtiiicares is;1:11cd in Form~sn.
(2) The provis!onal Certificate shall be valid only for a pericd of si;, months t':s tm th~ date o:· issue {Wi;,::,:.,:,u tll.> ~\'l~l "•~••c, , •· •.
of pe:mnnent Certificttte, whichever is earlier.
788.(50) ·1::r'r 11 Certificate fo~ the Applicant migrated from other State to the State of Chhattisgarh.- In case, where the Applkant is a migrant from other States. Competent Officer shall issue a certificate in Form-4C. after making tletaHed inquiry, if neces<:;11ry, t!1rough the District Magistrate or V~rification Committee or through Vigilance CeH, regarding his social status in that State:
• I
Provided that such certificate holder shall he eligible to avail the facilities provided to Scheduled Castes, Scheduled Tribes or-Other Barkwaro Classes, as the case may be. in that State -from which he has migrated.
12 ln-vo!antvy Migrn.tion..- Goverr.iment .employees \)f \!ndi\1;<led Madhya Pradesh and such · other offteerS a.r.d employees of Corporation, CommissiO!l, So:trd and Public Undertakings, who have been allocated tc !he Stah! of O·,hittisga.11 w1.:: to division of cadres hetween State of Madhya Pradesh and State of Cnhattis.garl-. under Ma.tUt_'f:l. Pr-J.de.;h Rcorg~,,izatk••• Act. 2000 (No.28 0f 2000) such employe,~ ,m<l his family ml;!mbers, ff they belo:1g to Scht!duitd Castes or Scheduled Tribes or Other Backward Class•: 5 m !..;e St:ut cf Cht•~t!isg:!rh shill be oee:ried w luiVe been migrated involuntary from the Stak 1i •/·1rli!y1 }l:mc'esb to the 'State of Chhatthg~rt1 ,1,:d they shaii be issued Certificate and CH1>:,PTE~ -U:
VERHX:1\TlON 0~ CFRTIF1C.\'!'E c ,:n-.;titut•: 7.Jdrk:. l.i:,~1 Cert1fir,,tc-: "hrffkatior. Committee having Jurisdiction , vr one or mere d1~·ncts. for the:! vt.-:riJ 1«;.!lc ·on 'of ccrtific,J.tes issued by rhP- Competent Authority, as un ier:- 11) /,<.'.titt'n ia: -:..:I:<',t'>r ,. ~ ·::;,;tlut:r f'oH,~cror posted at District ~ead(jimtt.e, ni):;:111,iate<l by CoHect,,r:
(::>) Ot,e Cffkv 1~0~ b..:hrl' !l.·..: rank of ..:lass H, i:>e!ongit>g to Scheduled (c, One ;.}ffice::- not hdmv the rank of cb.s::. H, belongir.g to Scheduled Casie, ,1oro:nated by Co!!~ctor;
(d) Ore C)ilker not below che rank of dass Il, belonging to Other Backw:m~ C!ass, r.aminatcd by Collector~ te) A subjt,.:t ex.pert offtcer or Class Hi, ... ._c:.:utive employee, nominated by Di~<:tor. Tri!)al Research and Training Institute;
Chairman Member Member Member Member ,.§'11 ::pw m ~ 2 ~ 2013 . ,
(f) Assistant Com11 ,.:.1:>1oner, Sched~led Tribe and Scheduled Caste.
Development Department.
788 (51) Member Sec~truj::-;
(2) In case on the post. of Subject Ex.pert Officer or Class III executive employee, an appropriate officer or employee is not available- for the Verification Committee then the Director, Tribal Research aI1d Training Centre Institute. Raipur may appoint any retired officer or a Class III executive employee as member.
(3) For the nominated retircri Subje<.;t cxpen Offu: er or Class III executive employee in the Verification Committee. honorarium shaH be determined bv the State Government.
; .
(4) Mee!it1gs of the V:. ificalion,.Cornmittee, ns required shall be held on a fixed day, every week:
But the m~f' . .ing of the Committe~ may aho be convened on the direction of Chairman with a short notice cf one day.
15 Verification of Certif\i~te and reforencr '1• Ve;-ifkatiu' -~01.cmittee.- (1) If the concerned public employer, educ.- · · ml institution or a statutory body the State Government or the Central Government, as ii ;ase may be. rece:iveE a complaint or raises a doubt that the person appointed.
admitted, eke-~ ' · med or nominat~d has obtained Certificate·wrongly or fraudulently then he/it shall ask such fll'i 1 to file an affidavit in Form-28 and shall refer the matter to the Verification
(2) Verification Com; i ke shall q!rify about 10% of the total number of Certificates issued by the Competent Autho ·it y, as. sawpie inquiry through random sampling method. The AppHcant shall not be at lib.:;rty to s~ek inform,Hion from the Venfication Committee as w why his certificate has been selected for vc,ification.
(3) Verification Commiltee m:iy direct any Applicant to submit application in Form-lC along with affidavit in Form-2C and shall exhibit such document as required under sub-rule (3) of Rule 3, nec:e&:;a11 to verify his social status.
(4) A Non-Appiicant, instead of referrif,E a ce..:ificatc to the Verification Committee may also direct the Applicant to get his certificate verified by the Verifi~ation Committee. In such cases the Applicant shall submit his original cerlific:lte, an application in Form-IC along with affidavit in Form-2C and document as required under sub-rule (3) of Rule 3 ..
(S) In case of direction from Verificaf~m Committee under sub-rule (3) or direction from Non Applicant under sub-rule 4 to verifying Certificate from the Verification Committee, the Applicant shall be bound to s bmit the application as mentioned above along with affidavit and documents as required under .ub-rule (3) of Rule 3 within: a period of not more than a month, 788 (52) failing which the committee may decide e:x .. parte and Certificate of such Applicant shall be forwarded under Rule 18 to Scrutiny Committee:
Provided that where applicant 1'atisfies the Verification Committee, that application, affidavit and other documents could not be submitted within prescribed time limit of one month, due to adequate reasons, the Verification Committee may extend the time for the verification ·Of certificate of the applicant.
16 Registration of application by the Vermcation Committee.- (l) Verification Committee shall register the applicatioi'~ for verification received from Applicant or Non-Applicant in a register as prescribed in the Form-SD.
(2) Verifk.ntion Committee shall send receipt in Form-3D to the Applicant or Non-Applicant, as the case may be, within 7 days of the receipt of application.
l7 Ve:rificatiora of Certificate by Verification Committee.-(1) The Verific(ltion Committee, on being satisfied with the application and documentary evidence annexed therewitJl shall issue verification certifica.te- in Form-4D(l} to Scheduled Castes, in Form-4D(2) to Scheduled Tribes and in Form- 4D(3) to 0ther Backward Ciasse~ to the; Applicant, his guardian or Nor.-•Applicnnt, as the ca.se may be,, withm a period of not more- than one mont11:
Provided that if the Applicant, his guardian or Non-Applicant, as the case may he, requests to send Ok, same by po~;t, the committee may send the same by registered post.
(2;,\' Vc,tification Committee sluill maintain details of the verified Certificates in Form~SE.
18 Procec:h1re where Verification Committee is not satisfied with the documeutary evidence.~ (1) Where th( .. Verification Committee is not satisfied with the documentary evidence annexed with Application, it may, within fifteen days from the date of receipt of application or within fifteen days of reference by Non-Applicm:t shall inform the Applicant or Non-Applicant, it any, stating the reasons of non-satisfaction thereby and shall give the Applicant, au opportunity to be heard:
Provided that the Verification Cornm,ttt:e ;;ball complete heatings in not wor.'.: than three months and in case where the Committee is u1 opmion that the Certificate seem'., to have been obtained wrongly or fraudulently it shall forwaro the origma• certificate aloni; wilh rdcvnm documents and its findings to the Scrutmy Comn;1ttt;e for inquiry under Rule l.;J ,tr1d sha11 a!so it1fonn the Applicant an.d Non-Applicant, it any.
(2) Veri1k::ition Comrnittet~ shall maintain details of forwar01;;;.::i certificates to the Scrutiny Committee in F'>rm-SF.
788 (53) Chapter IV Inquiry, Cancellation and Forfeiture of Certificates 19 Registration of the Cases by High Power Certification Scrutiny Committee.- (1) The Higher Power Certification Scrutiny Committee shall register the referred cases by Verification Committee or by the State Government or by the state Government in Form-SG.
20 Inquiry of the Case through Vigilance Cell. - (1) The Scrutiny Committee shaH forward the Certificate and copies of all relevant documents in cases referred to it by Verification Committee or by the State Government or any other authority in Form-6A to the Vigilance Cell constituted under Deputy Superintendent of Police;
(2) The Deputy Superintendent of Police through subordinate Police Inspector shall inquire into the case and inform Scrutiny Committee accordingly;
(3) Police Inspector of Vigilance Ceil shall --
(a) search places of local residence, d~micile and general residence of Applicant or the city.
town or village of his origin before migration;
(b) ascertain the truth regarding the Social Status as claimed by the Applicant or his parents or his Guardian, as the case may be. on the basis of public documents;
(c) verify the informatior. stated in the application submitted to Verification Committee by the · Applicant on the basis ofreJevant public documents and reliable private documents~
(d) obtain information from Village Kotwar. Village Sarpanch, Halka Patwari, Local Ward Member, Other Public Representatives, Local Gazetted Officers, such local members already having a Certificate and who are knowing well the Applicant and if any of them agrees to record his oral statement then he shall record his statement accordingly o.r shall request important witnesses to give their .statement on oath and in case they agree. shall obtain the affidavit accordingly and give a copy of the same to the witness concerned;
(e) give an opportunity to the Applicant himself and parents of the Applicant and shall record the statement of witnesses indicated by them or shall obtain their affidavits;
(f) if during the examination it is found that the Applicant or any other person has maliciously forged the document, after getting the photocopy of the relevant pages, seize the document · with the help of local police and shall seal and send the document to Deputy Superintendent of Police of Vigilance Cell and shall a receipt and copy of the sent. to the authorities having custody of the documents;
(g) submit his report along with alJ documents to the Deputy Superintendent of Police after completing the investigation.
\
(4) Deputy Superintendent of Police, ~fter obt~ining ncces~:~ . ,·· mission of the Scrutiny Committee shall send the document seized by the Police Inspector· ;· t-:Jrcns:c test and to handwriting expert along with appropriate noting.
(5) The Deputy Superintendent of Police shall submit 1he Inqu;ry Report containing his clear opinion regarding social statu~ of the Ap;:>licant, along with docui. ts received frnm Police Inspector I and conclusfons of forensic and handwriting expert to the Scrutiny Committee.
(6) The Scrutiny Committee shall examine &1Jch. report and 1,1 ...::.~e it finds any dr>ficiency jn the repo1t shall revert the same to the Vigil:.lnce Cell after indic:di.ing such defickncy and may direct for ii,quiry on specific is~ues.
(7) Police Inspector and Deµuty Supr-rintcndent of Police '->hall maintain detail,;; of above mentioned investigation of the ca&es in Form-SH.
21 Action oo the Report of Vigilau\;e Cell- (1) if in .:he Ihqu[r:1 Report cf VigihrKc Cell. dnims regarding social status of the AppHcant hHs bcei1 reported an just and µroper then there sha.11 be no furr.ber 2etion needed by the Scrntii-tJ Committee imd if shall intimate accordingly to the con-cemecJ verlficadot~ Cw11mlttGC. or: tho St.1m Gtwrrnm~nt. af. the case may be, and to the Applicant.
(2) If the matter is referre:d by the State G,;vemmem, the case shall be filed/c;osed at the State Government level with intimation to the Applicant and if the matter has oeen referred by the Verification Committee. then the Verification Committee after due verification in the manner provided under Rule 17 shaU ser.d the Original and Verified Certificate to the Applicant or Non App!icant. as the case may be.
22 Inquiry by High Power Certi.ficntic:a Scrutiny Committee• (1) Where the Scrutiny Committee is ~ot satisfied \Vith the social status claim of the AppHcam:, according to the inquiry Report of the Vigilance Cell the committee may through registered post shaH issue a show-cause notit:t! lv Applicont in pre&cribed F'->rm .. 6R aloni with report of the Vigilance Cell and the copy of such notice shall also be given to the Non-Applicant (if any) als".
(2) Af1er on receiving the reply of the Applicant, the Scrutiny Corrwtitcte si1all convene a meeting wherein it shall direct. the AppHcaut to pruducc his/her Certificate in original a'?G. Applkant shall be given adequate opportunity ot he.aring ur.d procucing e'tide'J.~e.
(.~) The Scrutiny Commin~ shall also i&:r.ue a putiic aotice regardil'g the hearing. which shall he widely publicized in the village or announced !ly beat of drum, advertisement or through some ot½e.!' con,1cnient me)!Jls, so th::.t a..iy ~r~on or jnstitution may support or opp~e the applicant's claim and such person or institution ~halt aiso be accorded an opportunity of hearing and p!Oducing evidence, if any.
@Jlfl•I~ ~, ~ 2 ~ 2013 788 (55)
(4) After giving reasonable opportunity of hearing to the Applicant or to his guardian (in ca_se the ··· applicant is not an adult), Scrutiny Committee may conduct such inquiry. so as to consider the claim and other objections.
(S) Scrutiny Committee may send the notice or summons for service to the Tehsildar, Additional Tehsi!Jar, Nayab Tehsildar, who shaH serve the notice in the manner as directed in Form-6C.
23 Decision of tl1e Scrutiny Committee and proceedings thereafter.- (1) After hearing bo:h the sides in 'mpport and against the claim, the Scrutiny ~ommittee ori being satisfied with regarding the genuineness of the claim of the Applicant shall direct the concerned Verification Committee .
to issue a Verification Certificate, if applied so.
(2) If after hearing the Applicant regarding his claim of Social Status Certificate the Scrutiny Committee. comes to the conclusion that the claim of the Applicant is not genuine, it may pass a • • i ~ t • V :
reasoned order and cancel the Certificate
(3) The 'Scrutiny Committee while passing order under sub-rule (2) shall authorise an officer of the employer, educational institution, local authority, the Central Government or the State Government to file complaint under sub-section (2)of section 10 of the Act and forward attested copies of;all documents related to the case to such officer for further proceedings.
(4) The Scrutiny Committee while passing order under sub-rule (2) of this Rule shall issue instruction to" the concerned Collector to investigate, whether· the the Competent Authority knowingly or having knowledge that such· certificate was false has issued such False Social Status Cf 1tificate or any other person has abetted such offence and the Collector shaJI forward his report to t ;1e State Government, within three months.
(5) The Scrutiny Committee after passing the order of cancellation of False Social Status Certificate ' • shaH confiscate it and details shall be entered in the register as prescribed in Form-SI and such Certificate shall be impressed as "Cancelled and Confiscated".
( 6) Copies of the order passed by the Scrutiny Committee shall be sent to the Non-Applicant, if any, and to the Applicant by registered post immediately after p1ssing such order. If the Applicant or ... a~y R~~f. p~rs9-t1 p~sen~ in t}_le .office demands copy of the order, the same shall be supplied to , the person on payment of appropriate fee. ..
24 Action against false Certificate holder.- The officer of the public employer, educational institution or a statutory body, the State Government or Central Government as the case may be, who is authorised by the Scrutiny Committee shall on the basis of the attested copy of the decision oassed by the Scrutiny Committee-, shall file a written complaint in the Police Station under sub-section ( 1) ,of Sr,etion 154 of Climinal Procedure Code, 1973 (Act no.2 of 1974) against the said False Social Status Certificate.holder.
788 (56) ~~ ~. fc::TTcF 2 ~ _2013 25 Action against the abettor and Competent Authority issuing False Social Status Certificate.~ The Collector of the concerned district shalJ file written complaint against the Competent Authority issuing False Social Status Certificate and the abettor of the offence.
CHAPTERV MISCELLA.t~EOUS 26 Procedure for issuing duplicate of Certificate and Verification Certificate- Where an original ce11ificate or verification certificate reiating to an Applicant has been lost or stolen or destroyed due to natural calamities like floods, earthquake etc or on request and after depositing fee as prescribed by the State Governn,cnt. Competent Authority or Verification Committee as the case may be, may issue the duplicate on the basis of original document kept in such office. There shall be a clear .
mention of "Duplicate Copy" on such Ceitificate or Verification Certificate.
27 Notice regarding Issuance, Verification or Cancellation of Certificate- (1) Competent Authority, Verification Committee and Scrutiny Committee. as the case may be, sha11 display the infom1ation regarding issuance, verification or cancellation of Certificate every month, before the Fifth day of the month on the office Notice Board and shall also send the information to local autonomous institutions and bodies. municipal corporation. municipality. village panchayat etc. for their records and shall also send the information through District Information ,centres. in order to display it on ascertained website.
(2) Competent Authority shall also send the information regarding issue of certificate and cancellation of applications, every year by 31 st December to the, State Government, in prescribed Form-7A.
(3) Verification Committee shall send the information regarding verification of certificates.
cancellation of application, cases forwarded to ~- utiny Committee every year by 31 st December to the State Government, in prescribed Form• 7B.
(4) Scmtiny Committee shall send the information regarding inquiry on the complaints referred by I' the State Government and Verification Co~mittees and cancellation ot' Certificate, every year by 31 "' December to the State Government in prescribed Form~7C.
By order and in the name of the Governor of Chhattisgarh, MANOJ KUMAR PINGUA. Secretary.
To, Competent Authority, Form- lA (See Rule 3(1)) , o'.J h, Application For Social Status Certificate Sub-Division ................. District. ................... .
Sir.
788 (57) I beg to state that in order to avail facilities given to Scheduled Castes/Scheduled Tribes/Other Backward Classes, U my son/daughter requires Certificate of Social Status. In this connection following information is being submitted, namely:- 1 · Name of the Applicant 2 Father's Name of the Applicant 3 Applicant's marital status:
4 Name of the Husband (in case of female applicant) 5 Date of Birth of Applicant 6 Caste (For SC only) 7 Present Address in full: MohallaN/ard Vil !age/Town/City ....................... .
Block.................... Tehsil.. ................. .
District. ............... .
State ................. .
8 · Permanent Address in fuil: Mohalla/Ward Villageff own/City .................. ~····· Block ..................... Tehsil. .................. .
District.. .............. .
Sulte ................. .
9 Applicant's Date of Birth:
(a) if before 10/08/50 for SC and 6/9/50 for ST;
(b) if before 26/12/84 for OBC Married/Unmarried MohaHaiWard ................ .
Village/Town/City ........... .
then. place of birth of applicant; or if after these dates then Block. ...... Tehsil... ..... .
permanent residential address of his Father/Ancestor · .District.. ...... State ........ .
IO Head ef the Fa•nily residing on the above-menHoned address N:ime .................... .
on the above-n~entioned date. Relation with the Applicant.. ..................... .
788 (58) 11 Details of the places where the Applicant/his father/ancestors have stayed from I0/08/1950 (with respect to SC), ,· 6/09/1950 (with respect to ST) and· 26/12/1984 (with respect to OBC) till the present day 12 Applicant's Caste/Tribe (including sub-caste) 13 Whether it is prescribed for the State or the District vide Notification dated 26/12/1984, as amended for OBC under Madhya. Pradesh Rcorgan isation Act., 2000?
If yes, its serial number Id. Attach attested copies of the following documents:
( I) Below-mentioned documents of Applicaat' s fathcr/ancestorn mentioning thc:r casie:-
(a) Re ,t;nue document of ancestors (case fiie);
(h) Jama-Bandi (;;urwy) or Girdawari bl;
(c) ~mt~ Settlement; OR
(d) De:: ~mer.~ 0f R:g!u-: (19.:-:4); OR le) Survey of ~•\:,rest De:1awncnttFocest Kight:, Certificate; OR
(f) Admission R~gisler of ed'.,catirnrni :nsthtition; OR
(g) Register of Birth or Death; OR
(h) National Regi::rer nf Citizens ( 1949); OR
(i) ,.:opy of Ca~,•:: Certificak, is::.;1cd e~rlier t~> Father, Ancestor or a re!ai:ive; OP..
(i) Ceasu~ (1931).
(2) Such domicile c~rt:fic,m., or any ot!ler dncmm:nt verifying th:it ancestor,,, ohhc ar•plicar:: wer-:; residing in the geographical limits of Chhattisgarh h:;fort> 1.he d::tc 0/08/i 950 {Scheduled Castes), 6/09.i I 950 {Scheduled 'fribf,<;) Gr 6/l 2/ l 984 (Other Backward Classes);
(3) Family Tree commencing frem ancestors to Caste certificate holder as obtaif!ed r.y Patwa.-i.
(4) If applicant's father :<;/were an employee of State Government and in re!Mion to SC/ST/OBC, before dated J0/08/1950, G6/09ii950, 26/12/l984 where residrnt o: existing Slate of Madhya Pradesh ai:;d wen.: ai:ocaied to tk State of Chhatlisga1·h 1.m S~.:.:.tc Reorganization, related documents Details of the atta :hed documents Yes/No Yes/No . , .Jf:i m11w1~ ~. ~-2St1m-,,.H-:2rn=--~-:--
(5) If the applicant belongs to OBC and his father/mot~er is a government employee, document verifying their post and income _ certificate or copy of Form 16 of the preceding financial° year.
(6) Envelope having full and legible address of the Applicant bearing adequate postage stamps (in case rhe certificate is des.ired through post)
(7) Affidavit of the Applicant (prescribed in Fann 2A) --788 (59) • Yes/f~o Yes/No Yes/No I hereby solemnly affirm that the information contained in the application is true and correct to the best of my knowledge and belief.
Place~ Date:
(Applicant's Signature) 788 (60) Form-lB [ see Rule 15 (1) ] Office of the .............................................. .
SI No ........... · .. . Date .......... .
To, Chairman District Level Certificates Verification Committee District ......................... , Chhattisgarh.
Sub.: Verification of Social Status of Shri/Smt./Ku ..................................... , S/o,/D/o,W/o, .............................. ·., resiqent of. .................... - reg.
Ref.: Social Status Certificate No ................ , dated .......... , issued by Competent Authority ..................... District. ................... .
Sir, Shri/Smt./Ku ..................................... , S/o,/D/o,W/o, ............................... , resident of ..................... , was appointed/admitted/elected/selected against posts/seat reserved for Scheduled Castes/Scheduled Tribes/Other · Backward Classes in this institution/local authority/department on the basis of Social Status Certificate No ................ , dated .......... , issued by Competent Authority, ..... : ............... District... ................. .
2. On the receiving a complaint that the Certificate has been wrongfully or fraudulently obtained, it is hereby decided to get the above Certificate verified by the District Level Certificates Verification Committee.
3. Original/Attested copy of the Certificate of Shri/Smt./Ku ............................ is enclosed herewith. Kindly verify the above Certificate in prescribed manner am.I time and report the tmdings to this office.
4. If Committee finds any prima-facic evidence, that the above Social Status Certificate was obtained wrongfully or fraudulently, kindly intimate, so that the concerned applicant may be directed to produce before you evidences in support of his claim.
Eucl.: As above (Original/ Attested copy of Social Status Certificate) Signature Name nnd Seal ~ffiflll~ ~. fc::TTCfi 2 ~ 2013 788 (61) Forrn- lC [ See Rule 16(3&4) ] Application before District Level Certificates Verification Committee To, The Chairman, District Level Certificates Verification Committee, Sub: Regarding Verification of Scheduled Castes/ Scheduled Tribes/ Other Backward Classes Certificate Sir, I, the undersigned ________ _, Father/Husband's Name ______ _ Post ___ ~ Department _____ hereby present the Social Status Cettificate (original/copy) of M.r/Mrs/Ms. ______ (Applicanfs Name), Husband/Father's Name _______ _ for verification according to the guidelines of Verification Committee/Non-Applicant'------- (Public Planner/Educational Institution/Constitutional Unit/State Government/Central Government). I attach the following documents for the verification of claim of Mr./rs./Ms.
l Applicant's name and surname 2 Name and surname of Father of the Applicant 3 Name and Surname of Father's father (Paternal Grandfather) of the Applicant 4 Name and surname of Mother of the Applicant 5 Name and Surname of Mother's father (Maternal Grandfather) of the Applicant If Applicant is a lady, her Husband's name and 6 Surname 7 Applicant's Date of Birth:
8 Place of Residence- S.No. Place of Mohalla/W ard Village/Town/City Residence number
1. Applicant's present place of residence
2. Applicant's place of residence in ~ , State of Chhattisgarh Tehsil District Date or and Year of State Residence \ 788 (62)
3. If Applicant's Date of Birth is on or \ before 10/08/1950 (SC)/ 06/09/1950 (ST)/ 26/12/1984 (OBC), then His/Her permanent address on such date ' If Applicant's Date of Birth is after 10/08/1950 (SC)/ 06/09/1950 (ST)/ 26/12/1984 (OBC), then His/Her Father/ Ancestor's permanent address on such date
4. Place of Residence of Applicant's Father in Chhattisgarh State
5. Permanent address of Applicant's Paternal Grandfather Residence :
9. Educational Information:
S.No. Applicant's Educational Primary Seco~dary Higher University Information Secondary
(1) (2) (3) (4) (5) (6) - 1. Y e~r of Education
2. Name of Institution '-.
3. Village/City /State '
4. Block/Tehsil '
5. District/State @ule•1~ m, ft::rtcf; 2 ~ 2013 788 (63) ======== ================================================================:::::::;:~===:=. :-: :r;::· S.No. Educat onal Information Primary Secondary Higher University· .. ~ . .;.~--~ fl;,·," .'· of Ar Jlicant' s Father Secondary ()) (2) (3) (4) (5) (6) I I. Year of Education
2. Name ( f Institution
3. Village 'City/State
4. -Blockf 'ehsil I -
5. Distric' 'State S.No. E<iucat onal Information Primary Secondary Higher University of Apnlicant's Mother .
Secondary
(1) (2) (3) (4) (5) '(6)
1. · ' Year of Education .
2. ~ame cf Institution \
3. V-illage ·city/State
4. .6iockr ehsil ·• ---
5. Distric1 State S.No. · Educat onal Information . Primary Secondary Higher University of Ap icant' s Father's Secondary Father .
(1) (2) (3) (4) (5) . , (6)
1. Year of Education
2. 1,·::.:me C'f Institution
3. Viilage City/State /
4. BlocktTehsii
5. District 'State l 0. Infom:ation relatmg to Property:
S.No. ~mmovable Area P.H.N. R.I.C Tehsil/District Year of property/ Agricu !tural obtaining/buying Land/J--louse/Shop/Others property (I) (2) (3) (4) (5) (6) (7)
1. Crr Appiicanf s Fat!:er's ' name.
2. On Applicant's Paternal Grandfather's Narr.e
3. On Applicant's Maternal Gr:mdfather's Name m1'h-111~ (~, ~ 2 ~ 2013 j 11. J,nfotmation mla._tjng· to ·caste:
S.No. Relative Caste Sub-Caste Clan ' (Gotra)
(1) (2) (3) (4) (5)
1. -- Applicant's Father
2. Applicant's Mother's Father
3. If Applicant is a Lady, then her Husband ' I
12. Information relating••, Occupation:
S.No. Relative· Traditional Occupation I
(1) (2) (3)
1. Applicant's occupatier!
2. Occupation of Ae12lic.1nt's Father
3. Occupation of Arnli,·1m'<; Paternal I : Grandfa .. her .
I --i Occupation of ApnJ i.::o.i:,t.' s Maternal 4. ' . . . ' i Grandfather I ---
5. i Occupation of :\;-;:ilk~-:• s sp-~'..:se I I
13. Applicant's Mother tong11e ·
14. If Applicant's caste hJ.s - · :paratc dialect, then ,1ame of the dialect J 5. •r Applicant's Caste has . God/Goddess the:: name of •"le God/Goddess J 6. Name of important God~"-J')ddc:~-,es of Applicant's caste
17. · ~amt of Folk Dances of Applicant's Caste
18. Name of Folk Songs of Applicant's Caste
19. Name of important festivals of Applicant's Caste
20. Whether matrimonial relation with son/daughter of father's sister is permitted in Applicant's Caste?
21. · Whether matrimonial relation with son/daughter of mother's brother is permitted in Applicant's Caste?
22. Whf'.ther q1stom of Bridc-Pricini, is. µ1evalent lfl Applicant's Caste?
23. \Vhether custom of dowry i5. prevalent in Applicant's Caste?
24. Name of those Castes/Clans with whom marriages of Applicant's Caste/Clan are possible
25. Name of those Castes with whom Applicant's Caste has the relation of Roti (Bread)
26. Name of Castes those are equivalent to Applicant's Caste 27 Applicant's Religion 28 Religion of Applicant's father
29. Details of Applicant's Relatives Clan Sign Line (Gotra (Totem) Chinnha)
(6) I Present Occuoation
(4) . / l ~ti]flll~ m, ~ 2 n:@K.R 2013 S.No. Detail Father's Mother's Husband of Brother Brother Mother's (Paternal (Maternal Sister Unde) Uncle)
(l) (2) (3) (4) (5) I. Name . 2. Caste
3. Sub-:-Caste
4. Clan (Gotra)
5. Occupation
6. ViUageffown of Residence
7. Tehsil
8. District
30. Attached documents:
( 1) Below-mentioned documents .of Applicant's father/ancestors mentioning thefr caste:- a · Revenue docl.!ment of ancestors (case file) b Ja,na-Bandi (Survey) or Girdawari b I c State Settlemer.t; OR d · Document cf Right<; ( 1954 ); OR e Sun·ey of Forest Department/Forest Rights Certificate; OR f Admission Register of educational institutio.::i; OR g . Register of.Birth or Death; OR h National Register of Citizens (1949); OR Cor,y of Casre Certificate, issued earlier to Father, Ancestor or a rdative; OR J Census (191 !);
2 St.·ch dorniccte certificate or any other document verifying that ant· sto:-.~ ,1f ,he applica.nt were residing in the geographical iin,its of Chhattisgarh berore the date · 1070811950 ,Scheduled Caste), 6/09/1950 (S, '.~d,ded :'ribe) or 26/12/1984 (Other Backward Class).
· · '.H usbaritl>lffl 1oit.sW11Wrs . I 1 Father's Father Sister (Father inlaw)
(6) (7) 3 Family Tree commencing from ancestors to Caste certificate Yes/No holder as obtained by Patwari.
4 If applicant's father is/were an employee of Yes/No State Government and in.relation to SC/ST/OBC, before dated · 10/08/1950, 06/09/1950, 26/12/1984 where resident of existing - State of Madhya Pradesh and were allocated to the State of Chhattisgarh un State Re-Organization, related documents.
5 If the applicant belongs to OBC and his father/mother is a Yes/No government employee, document verifying their post and 6 7 income certificate or copy of Form 16 of the preceding financial year.
Enveiope having full and legible address of the Applicant . bearing adequate postage stamps (in case the certificate is desired through post) Affidavit cfthe Applicant (prescrib~d in Form 2A) Yes/No Yes/No I hereby soleninJy affirm that the i,nformation contained in the application is true and correct to the best of my knowledge and belief (Applicant's Signature) Place:- Date:
~'ffiflll~ ~, ~ 2 ~ 2013 Form-2A · [ See Rule 3(3)(a) ] Affidavit for issue of Social Status Certificate I Mr/Mrs/Ms. ______ , son/daughter of _______ , aged_ Year __ , occupation resident of ______ _ Tehsil ____ , District State ____ _ hereby solemnly affirm the following :-
1. That I have.applied for the issuance of Social Status Certificate before the Comp~tent Authority in Form IA.
Affix passport size photograph Signature of
2. That I have, according to the prescribed form, attached the copy of__ applicant documents along with the application letter before the CompetentAuthority.
The document mentioned above has been obtained lawfully by the person(s) authorized by me and I have not made any unauthorized amendment/omission/change whatsoever of any kind in the document mentioned above or its original copy by me or my well-wishers and according to the best of my knowledge, the above-mentioned document/documents have not been concocted with any malicious intention.
3. That I have attached the family tree showing relation with those relatives whose validity certificates have been attached with this application.
4. I hereby declare that, in pursuance of obtaining the Social Status Certificate, the information rendered by me in the Application-presented in the prescribed form before the Competent Authority, is true to the best of my knowledge and belief and if such information is found false or incorrect, then .
proceedings in. accordance with Section 8-13 of Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013 shall be initiated against me.
Signature ______ _ Name of the Applicant. _____ _ / I Verification I Mr/Mrs/Ms ________ son/daughter of ______ hereby verify that the statements mentioned in Clause 1 to 4 of this affidavit are true to the best of my knowledge and belief, and I verify them in full consciousness .
..
Signature _____ _ Name of the Applicant _____ _ --------- Form-2B [ see Rule 15(1)] Affidavit by Person appointed, admi~d, elected, named or nominated on the Resen·ed Seat I, Mr/Mrs/Ms ________ , Son/Daughter of Mr. _______ , Aged __ , Year __ , Occupation ___ _, Resident of ___ , Tehsil , District ___ , State ___ _ solemnly state the following:
( l) I have submitted an Application for the post/seat/benefit/service reserved for Scheduled Castes/ Scheduled Tribes/ Other Backward Classes.
(2) My appointment/ admission/election/naming/nomination have been made under the reserved post/seat.
(3) I have submitted my Social Status Certificate issued by Competent Auth~dty ______ _ (name and post of authorized officer) certifying that I belong to Scheduled CaS'".es/ Scheduled Tribes/ Other Backward Classes.
(4) The Social Status Certificate submitted by me has been issued by the prescribed cfficer and through prescribed process and in order to get such certificate, all infmmation rendered by me to the Competent Authonty is ltue to the best of my knowledge and belief.
(5) In case a complaint is received in connection with above mentioned Certifr:ate that Certificate has been obtained fraudulently or wrongly and if on this basis or otherwise, suo moto, an inquiry is held by the District Level Certificates Verification Committee reg.:rding my Social Sta:us or the Social Status Certificate is referred for inquiry to the High Power Certification Scrutiny Committe~ and if the above committee or committees after lnquiry and decision pass an order stating tiat Certificates has been obtaiued wrongly or fraudulently. my appointmenv'admission/eiection selection, pnfit gJven, facilities given, as the case may be, can be cancelleci/te1minatcdlexd1.1.if:d Wi!h tmmcdiate effect by the non-applicant (name of concerned public empl0yer/educational iustitution/Rtatutory body/ State Government/Central Government) _____ ., ~nd r shaH be liahie to refund the amount spent on such appointment/ admission/election!selection/profit /facilities given etc. and the above-mentioned amount may be recovered as an-ears of land revenue. and I shall a!so be Hable tc, ac:ion prescribed in Section 8-13 of Chhattisgarh Scheduled C:astes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013.
Signature V crific3tion I Mr/MnJ~!s____ _ ___ son/d,mghter of _______ .. berc1)) venfv , hctl t'1~ :::iatements mentioned in Clause to') of this affidavit, ·e- tf"I;:" in rtw t-··"•.t n: '11 1•!•11·.~- ::r,•e and :'• . .:~. :,:r,_, 1 verify them in full consciousnes~.
::: ;:g:v.,JlH'.C _* -·- ·-•-- .... ~- ......
f·:n ~ Ql ~11~~ r~r, l·r lnt ~'ffiftl(G ~, ~ 2 ~ 2013 . ' Form-2C [ see Rule 16 (3 & 4) ] Affidavit to be filed before District Level Certificates Verification Committee I, _______ _, son/daughter/wife of ______ , aged __ , Year __ , occupation. ___ , resident of , Village ___ ~ Tehsil ____ , District ___ ., State , hereby solemnly affirm that:
l. I have applied for· verification of my social status certificate before District Level Certificates Verification Committee in prescribed Form and in support of my claim, I hereby present this affidavit.
2. I have attached with my application, copies of the documents required Affix passport size photograph Signature of applicant.
under Sub-Rule (3) of Rule 3 in prescribed Format to verify Social Status Certificate before District Level Certificates Verification Committee. Above mentioned documents have been obtained by me legally from Competent A:ithority/authorities and I or any of my well-wisher have not made any correction/change/rectification and to the best of my knowledge and belief no forgery has been committed in such document/documents.
3. I have attached the family tree showing relation with those relatives whose valid caste certificates have been attached with this application.
4. I hereby declare that the information given by me in the prescribed format before social status certificate Verification Committee for verification of social status certificate is true to the best of my knowledge and I understand that in case the same is found false at any level, an action tinder Section 8-13.of Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of So~ial Status Ce1tification) Act, 2013 can be initiated against me.
Signature Place ___ _ Date ___ _ Verification I ________ son/daughter/wife of______ hereby verify that the statements mentioned in Clause 1 to 4 of this affidavit are true to the best of my personal knowledge and belief, and I verify them today on ___ , place--~ Chhattisgarh under my signature . ..
Signature itsBf~) ~'tllfl◄I~~. ~2~2013 -====~:.::::=====:::::;:::::::::::::================================================= Form-3A (See Rule 5) Office of the Competent Authority Division ____ ., District ___ , Chhattisgarh !nward No. ___ _ Acknowledgement of Application (Receipts] Dated __ _ · (Original copy of the memo should be given to the applicant and its counte1foil be maintained in the office) Received today ___ an application to issllc a Social Status Certificate from Mr/Mrs/Ms · son/daughter/wife of ____ aged ___ Year ____ occupation __ _ resident of . Tehsil ___ District ____ State ____ . Following documents have been received in original/attested copies thereof along with application:-
(1) Follow!ng document of the Applicant or Applicant's father/ ancestors mentioning his caste:
(I}~ document of ancestors (case file);
(ll)Jaaa-Smdi (Survey) or Girdawa.-i;
(ID)~ Seulement;
(IV)DocumenlofRights (1954);
(V)-Qmus (1931);
(VI) Survey of Forest Department;
(Vll) National Register of Citizens ( 1949);
(VIII) Register of Birth or Death;
(IX) Admission Register, in case father or ancestors were literate;
(X) Caste Certificate, issued earlier to Father, Ancestor or a relative;
(XI) Any other document which proves the caste, as claimed by the applicant;
(XII) ___________ _
(2). Such document duly attested.copy or copies of the documents verifying that his ancestors were residing in the geographical limits of Chhattisgarh on or before the date of Presidential Notification or date of notification in relation of Other Backward Classes, as the case may be;
(3) Family Tre_e given by Patwari mentioning from ancestors to Applicant.
(4) Affidavit of Applicant or his Father or his Legal Guardian in prescribed .Form-2A (m ongmal).
(5) Documents showing that parent of the applicant are officer/employee of the State Go.vemment and on or before the date of notification of Presidential Notification and were resident of present Madhya Pradesh and on reorganization of the then State of Madhya Pradesh they have been allocated to State of Chhattisgar' .
(6) For Other Backward Classes, income certificate of father for preceding financial year or certified copy of Form 16.
(7) Envelope having appropriate po<;tage stamp and complete and legible address.
Signature and seal of recipient 0~e11c; ~. mi'cfi 2 ~ 2013 1ss (71) ======================================================================== _·.·~--.::: :- Form-38 (see Rule 5) Office of the Competent Authority Memo for Return of Application [Return Memo] (Original copy of the memo should be given to the applicant and its counterfoil be r.1aintained in the office) Serial No. · Date: ___ _ The app; ication to :ssue Social Status Certificate by Mr/Mrs/Ms _____ son/daughter of ___ _ resiG':Pt of _____ lacks following documents. Hence, it is hereby directed that the following docL rr,,·:1ts marked as (a) be submitted with the application, so that proceeding to issue social status cerufa, 1~ cm be imtiated:- 1 ,. h · \ .. ·wrng document of the Applicant or Applicant's father/ af-cestors mentioning his caste:
\ l :..:. , , : document of ancestors (case file);
(1i 1 ."1 .1 •,andi (Survey) or Girdawari;
/Ill; :.,', ,ettiement;
( i \' 1 : , • __ ,nent of Rights (1954);
(_\\(. :'- ·-rI931);
1 \ l • .· •• ,. of Forest Department;
(Vl1: ··•~"ml Register of Citizens (1949):
(VU!, , ·u•;rer of Birth or Death;
(IX 1 \- ; 1 , ,,ion Register, in case father or ancestors were literate;
(Xl C'. •t ,.'l.'.rt!ficate, issued earlier to Father, Ancestor or a relative;
(XI'. A 1 ~ (•ther document which proves the caste, as claimed by the applicant;
(XII) __ ---------------
(2) S,.;_ I: - .,cument should be duly attested copy or copies of the documents verifying that his· an~r-st l'"" :.:re r..!siding in the geographical iimits of State of Chhattisgarh on or f?efore the date of Presidt>Pt. .. No;.fkation or Date of Notification relating to Other Backward Classes, as the case may be.
(3) Famil_ "!"ree gi,en by Patwari mentior.ing !"rom ancestors to Applicant.
(4) Affid.1, ,, of Applicant or his Father or !)Is Legal Guardian in prescribed Form-2A (in original).
(5) D0rn 1i.·ats -;howing that parent of the applicant are officer/employee of the State Government and on 01 hdl"-' the date of notification of Presidential Notification were resident of present Madhya Pradesh :•n.~ afr,~r reorganization of the then S~te of Madhya Pradesh they have been allocated to State of Chh;,i I i"!:ar!1.
( 6 J For ; 1H1"'r Bad·, .-·ar<l Classes, income -:ert!ficate of father for preceding financial year or certified
(7) Em::.,:~ .lJ'. m? appropriate postage stamp and complete and legible address.
Si£natr•·. rht: Applicant Signature of the Authority " To.
Form-3C (see Rule 6) Inability Memo (This form shall be printed on-the back of Form 2B) Competent Authority Affix passpon size photograph Sub-Division. ____ _ District. ___ _ Subject: Regarding inability to make available necessary document for issue of Social Status Certificate.
Signature of applicapt.
Sir, I _____ (Name of the AppHcant) son/daughter of _____ Post ____ ~Resident of ____ S0lernnly affirm that I bave applied for Social Status Certificate on ____ (Date) with Receipt No. _____ .But I am not able to n:a.ke available the required Llucu111~11tnry c•,ridence unrl~r suh-rule (3) of Rule 3 to substantiate my ciaim because:
(1) Nobody is/was literate amongst my Father or Ancestors or blood relatives of my Father;
(2) My Father or Ancestors or Blood relatives of my father did not have any immovable property and there is no document available regarding such immovable property;
(3) There is no entry regarding my father or ancestors in the public documents required under Rule 3;
(4) I do not poss{';ss any document could be used as a proof;
Hence I request you to issue Social Status Certificate after making inqul1y under Ruie 8 on the ba~i:') of the affidavit submitted by me. I shall submit before authority required informatfon at the time of inquiry, I shall present myself on the date fixed by him and shall give full cooperation to seek presence of desired persons to support my claim.
Signature ___ _ Verification I Mr/Mrs/Ms ________ son/daughter of. ______ hereby verify that the statements mentioned above in this affidavit are true to the best of my knowledge and belief, and I verify them in full consciousness.
Signature _____ _ Name of the Applicant. _____ _ I Form-3D [ see Rule 16(2)] Ofike of the District Level Certificates Verification Committee District ___ ,, Chhattisgai"h Inwa,d No. ___ _ Dated Acknowletlgement of Application [Receipt} (Original copy of the memo should be given to the applicant and its counterfoil be maintained in the office) Received today ___ an application for verification of Social Status Certthcate from Mr/Mrs/Ms son/daughter/wife of ____ aged ___ Year ____ occupation resident of ___ Tehsil ___ District ____ State ___ _ Following documen!s have been received in original/attested copies thereof along with application : ( l ). Following document of the Applicant or Applicant's father/ ancestors mentioning his caste:
(I) Revenue document of ancestors (case file.);
(U) Jama-Bandi (Survey) m Girdawari;
(III; State Settlement;
(IV) Document of Rights (1954);
(V) Census ( 1 93 l J:
(VI) Survey of Forest Department;
(VII) National Register of Citizens ( 1949);
(VIII) Register of Birth or Death;
(IX) Admission Register, in case father or ancestors were literate; . .
(X) Caste Certificate: issued earlier to Father, Ancestor or a relative;
· {XI) Any other document which proves the caste, as claimed by the applicant;
(X!!} ---------------- (2J Such document or duly attested copy or copies of the documents verifying that his ancestors were residing in the geographical limits of Chhattisgarh on or before the date of Presidential Notification or date of notification- relating to Other Backward Classes, as the case may be;
(3) Family Tree given by Patwari mentioning from ancestors to Caste Certificate holder/ Social Status £::ertificate holder.
(4) Affidavit of Applicant or his Fathe:i or his Legal Guardian in prescribed Form-2A (in original).
(5) Documents relating to parent of the applicant showing that they are officer/employee of the State Government and on or before the date of Notification of Presidential Notification were resident of present Madhya Pradesh and on reorganization they have been allocated to State of Chhattisgarh.
(6) For Other Backward Classes. income certificate of father for preceding financial year or certified copy of F01m 16.
(7) Envelope having appropriate· postage stamp and .complete and legible address.
Signature and seal of recipient ,_t,)~(74) Book No.
Serial No.
Form-4A(l) (see Rule 9) OFFICE OF COMPETENT AUTHORITY Division ____ District _____ Chhattisgarh SOCIAL STATUS CERTIFICATE (For Scheduled Castes) . (On sky-blue paper) Uate:
It is hereby certified that Mr/Mrs/Ms _______ son/daughter of _____ resident of village ___ _ . Tehsil ____ District ____ , belongs to ___ _ caste and according to Article 341, such c~ste is included in connection with the State of Chhattisgarh as Scheduled Caste and such caste is mentioned on the serial number ____ of Schedule 3, under Section 19 of Madhya Pradesh Reorganization Act, 2000. Therefore, Mr/Mrs/Ms ______ _ son/daughter of _____ belongs to Schedule Caste.
2- TI1is certificate has been issued under the provisions that in case the District Level Certificates Verification Committee or High Power Certification Scrutiny Committee during its ' .
inquiry/inspec~on finds the claim submitted by Mr/Mrs/Ms. _______ is false or fraudulent, the certificate sflall. be deemed to be cancelled with immediate effect and notwithstanding contained anything. undcr·any other: law fonhe time being in force, action shall be initiated under Section 8-13 of.the".fZbhattisgaili,Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social-Stafus,Certifroatiao) ~2013.
Signature Name of Certifying Officer Designation/Seal !
Book No.
Serial No.
Form-4A(2) (see Rule 9) OFFICE OF COMPETENT AUTHORITY Division _____ District _____ Chhattisgarh SOCIALSTATUSCERTIFICATE· {For Scheduled Trib2S} (On nght-pink paper) ,,,q 288 (75) Date:
It is hereby certified that Mr/Mrs/Ms _______ son/daughter of ___ -,--_ resident of village ___ _ Tehsil _____ District _____ , belongs to ____ tribe and according to Article 342, such tribe is included in connectjon with the State of Chhattisgarh as Scheduled Tribe and such tribe is mentioned on the serial number ____ of Schedule 3, under Section 20 of . Madhya Pradesh Reorganization Act, 2000. Therefore, Mr/Mrs/Ms _______ son/daughter of _____ belongs to Schedule Tribe.
2- This certificate has been issued under the provisions that in case the District Level Certificates Verification Committee or High PQwer Certification Scrutiny Committee during its inquiry/inspection finds the claim submitted by Mr/Mrs/Ms _______ is false or fraudulent, the certificate shall be deemed to be cancelled with immediate effect and notwithstanding.contained anything under any other law for the time being in force. action shaU be initiated.under Section 8-13 of the Chhattisgarh Scheduled Castes, Scheduled Tribes and. Other: Backward: Classes (Regulation. of Social Status Certification) Act. 2013.
Si~ Name:-ofCertifying-Offfoer D . tmulSeat esigna Book No.
Serial No.
Forrn-4A(3) (see Rule 9) OFFICE OF COMPETENT AUTHORITY Division _____ District _____ Chhattisgai'b SOCIAL STATUS CERTIFICATE (For Other Backward Classes) (On light-yellow paper) Date:
It is hereby certified that Mr/Mrs/Ms _______ son/daughter of _____ resident of village --~ __ Tehsil _____ District----~ belongs .to caste. This caste has been recognized as Other Backward Classes vide Notification no. F-8-5/25/4/84 dated 26th December 1984, as amended from time to time by subsequent notifications, and this caste is mentioned at serial uu. __ as Other Backward Clas& of Chhattisgarh State. Therefore, Mr/Mrs/Ms _______ son/daughter of _____ belongs to Other Backward Class.
2~ This is also certified that Mr/Mrs/Ms _____ does not belong to the category of creamy layer / / persons/ classes which have been mentioned in the circular nu. 360 U/22/93/ESTT(SCT) dated 8/09/1993 as amended by notification no. 36033/3/2004-ESTT(Reservation) dated 14/10/2008 of Government of India, Departmerit of Personnel and Training and in column 3 of circular number F-9- 3/2001 / 1-3, dated 24/06/2009 of General Administration Department.
3 This certificate has been issued under the provisions that rn case the District Level Certificates Verification Committee or High PO\vcr Cenlficatmn S:::rutiny Committee during its inquiry/inspection finds the claim submitted by \thiMrs/M, _______ ;,;false or fraudulent.
the certificate shall be deemed to be canceHed v, 1th 1mmea1atc ,.;1fec; amt n1Jtv,, ,,J.~t,1ndi11t~ ,:o,1• .. 111i::1J anything under any other law for the time hei11g in force. ,1ctic:n sha n b1:- iniu;ited uncte~ Section 8-13 of the Chhauisgarh Scherluled Castes, Scheduled Tribes ano Other Back v,1a;-<l Classes, P.2gulaiion of Social Status Certification) Act, 2013.
Signature Name of Certi(ving Officer Designation/SegI I Fonn-4B (See Rule 10) OFFICE OF COMPETENT AUTHORITY Book No.
Serial No.
Qate:
PROVISIONAL SOCIAL STATUS CERTIFICATE (On white paper) (Valid only for the purpose of granting admission and scholarship/stipend or any such other purposes in educational institutions of primary /secondary level) It is hereby certified that on the basis of affidavit submitted by Mr/Mrs/Ms ______ _ son/daughter of _____ resident of village ____ Tehsil _____ District ____ __, he/she belongs to ____ caste/tribe/OBC (not included in creamy layer of OBC) and according tc Article 341/342/Notification of the State Government, such caste is included in connection with the State of Chhattisgarh as Scheduled Caste/Scheduled Tribe/ OBC and such caste/tribe is mentioned on the serial number ____ of Schedule 3, under Section 19 of Madhya Pradesh Reorganization Act, 2000/ Schedule 4, under section 20 of Madhya Pradesh Re-Organization Act, 2000/ State List of OBC and Mr/Mrs/Ms ______ _ son/daughter of _____ belongs to Schedule Caste/ Schedule Tribe/OBC.
2- It is certified that annual family income of Mr/Mrs/Ms ______ _ 1s Rs.
3- Tnis certificate has only been issued for the immediate purpose of getting scholarship/stipend provided by Government of India/ State Government and the certificate is valid only for six months from the date of issue or till the issue of permanent social status certificate, whichever is earlier.
Signature Name of Certifying Officer Designation/Seal 7Bio( (JS~ , Book No.
Serial No.
Form~4-C (see Rule 11) OFFICE OF COMPETENT AUTHORITY Division _____ District _____ Chhattfsgarh SOCIAL CASTE CERTIFICATE (MIGRANT) Date:
This is to Certify that Shri/Shrimati/Kumari -------------------Son/Daughter of ---------------··-··--------of Village/Town -------------------------in----------------vi strict/Division -·-------------~-- ------------··-··---of the State/Union Teritory -------------------------- belongs to the -----------·-----------c---------Caste/Tribe which is recognized as a Scheduled Caste/Scheduled Tribe Under:-
1. The Constitution (Scheduled Castes) Order, 1950
2. The Constitution (Scheduled Tribes) Order, 1950
3. The Con"titution (Scheduled Cu;tes)(Union Teritories) Order, 1950
4. The Constitution \Scheduled Castes)(Union Teritories) Order, 1951 As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification) Order, 1956 the Bombay Reorgani:;ation A.ct, J. 960 th<" Punjab Reorganisation Act, 1966, the State of Himachal Pradesh Act, 1970, the Non:h Eastern Areas (Reorganisation) Act, 1971 and the Scheduled Castes and Sd1edukd Tdb~s ord".r<:: (Amendment) Act, 1976. · 5 The Constitution (Jammu and Kashmir) Scheduled Castes O1der, I 'J56
6. The Constitution (Andman and Nicobar Islands) .Schedulc',d Tribes Order, 1959 as amended by Scheduled Castes and Scheduled Tribes Orders (Amendment ) Act, 1976
7. The Constitution (Dadra and Nagar Haveli) Scheduled Castes Order. 1962
8. The Constitution (Dac!ra and Nagar Ha-veli) Scheduled Tribes Order, 1962
9. The Constitution (P0nd1chery) Scheduled Castes Order, 1964 I 0. The f:onstitution Scheduled T·ribes (Uttar Pradesh) Order, 1967 1 J. The Constitution (Goa, Daman And Diu) St:1iedu1cd Castes Orrl~r. 1968 l 2. The Constitution (]\;agaland) Scheduled Tribes Order, 1970
13. The Constitution (Sikkim) Scheduled Castes Order, 1978
14. The Constitution (Sikkim) Scheduled Tribes Order, 1978 *This Certificate is issued on the basis of the Scheduled Castes/ Scheduled Tribes Certificate issued to Shri/Shri mati/Kumari ------------------------Son/Daughter of ---------------- ----- -------------------------- of Villa geff own --------------------,----------------iP--------------------- ----------------District/Div 1s1on -------- ------------------------ ---of thf> State/Union Territory -------------------------~- who belong to the -------·· ------------------:-----Casteffdbe v1hich is recognized as a Scheduled Caste/Scheduled T,·;he in the State/Union Territory -------------------------~------issued by the -----------------------------( name of prescribed authority) vide their no ...................... dated .................... and the holder on thecertifkatc is not entitled tP :my conces~ian/ faci[1ties extended to Scheduled Caste/ Scheduled Tribes b;1 the Ge vemmem < : Cr.hattisgarh.
-:i,,~ .Shr;/Shri1.. 1tl.'Kumc1ri ----------------------------- and or his/her family ordinary reside(s) at village/ town -------- --------------- :Jf ---------------------------District/Division of the State of Chhaaisg:::.rh ..
* Applicable 1. Migrants only **Not applicable to Mtgnma-s Signature Designation (With seal of Officer) 788 (79) ~,:flw1~ m, ~ 2 ft@.:<;R 2013 ==========-=========================================================================---=--:t::a-a:::-~- --____ ,_ ---- Serial No. __ _ Form-4D(l) [ see Ruic 17(1) J VERIFICATION CERTIFICATE (For Scheduled <:;astes) (On sky-blue paper) Mr/Mrs/Ms ______ _ I scrJdaug_hter of _____ _ Dated:. __ _ resident of village ___ _ Tehsil _____ District ____ _, Chhattisgarh has been issued a Social Status Certificate serial no. ____ dated ____ by Competent Authority _____ . In the light of document _____ (details of the dcc:;mer.t), as required under Rule 3(3) of the Chhattisgarh Scheduled Caste~, Scheduled Tribes and Other Eackward Classes (Regulation of Social -Status Certification) Rules, 2013 and after the inquir:1 a_;[id s2tisfaction to this committee is verified.
2- Mr/fylrs/Ms _______ - sen/daughter of ______ resident of vil!age ___ _ Tehsil _____ Dist.-ict ____ _, Chhattisgarh is of caste/tribe is a Scheduled \ CastJ of State of Chhattisgarh. ucder A .. '1ic!e 341 of the Constitution, which is mentioned on the serial numb~r ____ of Third Schedufo cf Section 19 of the Madhya ~adesh Reorgani_zation Act, I
2000.
Investigation Officer District Level Certificates Verification Committee District ____ _ Chhattisgarh Inquiry Officer/Member Disa-ict Level Certmcates Vcrifica£mn Committee . District ----- Chh&tlisgarh Chairman District Level Certificates Verification Committee District ----- Chhattisgarh ..,. J Form-4D~2) [ see Ruie l7(1)] Serial No. --- Dated: __ _ I VERIFICATION CERTU'ICATE (For Sched11!-ed Trib£s) (On light-pink paper) Mr/Mrs/Ms son/daughter of ____ _ resident of village ___ _ Tehsil ____ District _____ , Chhattisgarh has been issued a Sodai Status Certificate serial no. ____ dated ____ by Competent Authority _____ . In the. light of document _____ (details of the document) as required under Rule 3(3) of the Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Rules, 2013 and after the inquiry and satisfactionto this committee is verified.
2-: Mr/Mrs/Ms _______ sor-Jdaughter of _____ i:t:sideni of viliage ___ _ Tehsil ____ District ____ , Chhattisgarh is of caste/tribe is a Schedukd Tribe of State of Chhattisgarh under Article 342 of the Constitutfon, which is mentioned on the serial number ____ of Third Schedule of Section 20 of Madhya Pradesh Reorganization Act, 2000.
Investigation Officer Inquiry Officer/M::ember Chairman District Level District Level District Level Certificates Certificates Certificates Verification Committee Verification Committee Verification Committee District District District Ctihattisgarh Chhattisgarh Chhattisgarh I,,.
l 'I ' j Serial No. __ _ Mr/Mrs/Ms Form- 4D(3) t see Rule 17(1)] VERIFICATION CERTIFICATE (For Other Backward Class) (On light-yellow paper) .son/daughter of Dated: __ _ resident of village ,....__ ____ Tehsil _____ District ____ _, Chhattisgarh has been issued a Social Status Cenificate serial no. ____ dated ___ by Competent Authority ____ . In the light of document _____ (details of the document) as required'under Rule 3(3) of the Chhattisgarh · Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Rules, 2013 and after the inquiry and satisfaction to this comm;ttee is verified.
2- Mr/MrstMs _______ son/daughter of _____ resident of village ___ _ Tehsil ____ District ----~ Chhattisgarh is of caste/tribe is a member of Other Backward Classes of the State of Chhattisgarh as per Notification no. F-8-5/25/4/84 dated 26"' December 1984, as amended from time to time, and this caste- is mentioned on serial no. __ as Other Backwarii Class of Chhattisgarh State.
3- This is to certify that tota~ annual family income of MrJM."'S/Ms _______ is Rs.
Investigation Officer · Inquiry Officer /Member Chairman District Level District uvel District l.evel Certificates Certificate~ Certificates V eriftcation Committee Verification Committee Verification Committee .... ~_,.... .... ,:~ ,! ... ~_ ..
District District District Chhattisgarh ·Chhattisgarh Chhatt:isga..-il .} I SL I f§'ffi{ll I~ (f',lfq;f ~ 2 ~ 2013 . ' ·Form-SA (See Rule 4) Format for Registration of Application received at the Office of the Competent Authority Case No. Date of receipt of Application 2 3 Name of Father's Applicant Name 4 5 Form-SB (Rule 10) Current Caste which Date of Address Claimed issue of Certificate 6 ·7 8 Format for Registration and Forwardiog of Application for Provisional Social Status Certificate received at the Office of the Competent Authority SI. Case No.
l 2 Date of Name of receipt of Applicant Application '.J .If Father's Current Name Address 5 6 Form-SC (Rule 13) Caste Date of which issue of Claimed Provisional Certificate 7 8 Fe,nnat for Registration of Social Statu~ Certificate Document.~ Date of forwarding to Competent Authority for Permanent Certificate 9 ~ St f .
i.
SL I I Case No., Date of Name of Book No., issue of Applicant and Serial Certificate No.of Certificare
2. J 4 Father's Current ! Certificate Name Address 5 Form-SD (see Rule 16) 6 of which Caste Issued 7 Detail of Name of Documents Issuing enclosed Authority 8 9 Format for Registr~tion of Application received for Verification of Social Status Certificate , ; ·.-_~l 1--f tf,t···1:1 1 , • ,,. < • •• ' • •• Case. ~teof Name Name of .Father's Current Date of Remarks No. .. receipt,of a~'cl :detail Applicant Name Address issue of . ·- ~ .
. Appliication of Non - Certificate Applicant 2 3 4 5 6 ·7 8 9 §ffiwl~ m, ~ 2 ~ 2013 Form-SE [ See Rule 17 (2)] Format for Registration of DocHments foll" Verification Certificate SI. Case No., Date of Name of I Father's Current Certificate Detail of Remarks Book No., issue of Applicant\ Name Addres3 of which Docume and Serial Certificate 1 Caste nts No. of I Issued enclosed Certificate 1 2 ,., 4 5 6 7· 8 9 .)
Form SF [ See Rule 18 (2) 1 Format for Registration of Detail of Application forwarded by the District Level Certificates Verification Committee to the Scrutiny Committee SI. Case No.
1 2 SI. Case No.
L 2 Name of Applicant/ Father's Name of whose Social Status· Certificate has been forwarded to the Scrutiny Committee for Investigation and · Scmtiriy.
3 Name and Address of Competent Authority issuing the said Certificate 4 Fonn-SG {see Rule l 9) - ' No. and Date Order of the No. and Forwarded Date of Social Status Scrutiny Certificate Committ ee 5 6 Format for Registration of Cases by Scrutiny Committee Date of Name of Father's Current Date of receipt ·receipt of Applicant Name Address of Verification Appljcation Certificate 3 4 5 6 7 Remarks 7 Remarks 8 - ;
Form-SH [ Rule 20 (7) 1 Details of investigation of Cases received from the Scrutiny Committee by the Police Inspedors (Vigilance Cell) (Separate Pages of Register be used for Each Case) SI. Case Name/Father' Date of Name of Date of Detail of Name, No/Name s - •-L- · receipt Police assigning Dates and Father's of Name/Curren of Case Inspector/s Case for Places Name,Post Applicant/ t Address of who has investigatio visited by held and Father's Complainant, been 0 Police other details Name/ if any assigned Inspector/ of-those Present Investigatio sfor persons address n investigati interrogated/ whose on Statements/ certificate Affidavit is to be obtained)}' Investigate Polic d Inspector/s during· investigation and date of snch action 1 2 3 4 5 6 7 8 Name, Father's Details of Details of Detail of Date of ' Date of Date of Name and other Public and Public Documents receipi of submissio ·Submissio details of Private Documents submitted to Forensic and nof n of . Applicant, his Documents Ceased by Forensic and Handwriting Investi- Investifather/mother, examined Police ' Handwriting report gation gation relatives and by Police Inspector/s, .expert by report by Report by other informed Inspector ls, during Dy. Spdtt. of the Police the Dy.
persons during investigation Police and, Inspector/ Spdtt. of int~rrogated/Sta investigatio date of· ..sto the ·Police to , tements/ n submissio11 .Dy.Spdtt. the . Affidavit of Police Committee ol,talned , by Police Irispector/s, .
during investigation and date of such action 9 lO tl i2 13 14 t5 . SI.
1 Form-SI (see Rule 23 (5)) Format for Registration of Details of Certificates Confiscated by the Scrutiny Committee Case Name/Father's Name Name and Address No; and Order No. Remarks No. of Applicant/ Address of Competent Date of the and Date of Applicant whose Authority issuing confiscated of Scrutiny Social Status the Social Status and ceased Committee Certificate has been Certificate Social ..
confiscated and Status ceased. Certificate 2 3 4 5 6 7 I m-nw1q m, ~ 2 ft:Rn::<iR 2013 -----..·==e+:~ Form-6A l see Rule 20 (l) l OFFICE OF HIGH POWER CERTlFICATlON SCRUTINY COMMITTEE SJ No ............ .. Date ......... ..
To, The Deputy Supdtt. of Police Vjgilance Cell (Investigation and Scrutiny of Social Status) Raipur .
Sub.: Investigation and Scrutiny of Social Status of Shri/Smt./Ku ..................................... , SloJD/o,W!o, ................................ ,resident of ..................... - reg.
Ref.: Letter· No .. ; ............ Dated ............... .". of District Level Certificates Verification Committee .................. ./ Govt. of Chhattisgarh (Name of Administrative Department) Kindly find endm;ed herewith C~se No.: ...................... , of Shri/Smt./Ku ............. .,•••••c•••••• .................... ,. •• ,.<; S/o,/D/o;V,f/o, ............................... , resident of ..................... , suhmitted for fnve;;tigcLfoa and scrutiny by District Level Certificates Verification Committee, District.. ................. , Chhatfo,garh r Govt. of Chhattisgarh .. : ................ (Name of .
Administrative Dep,i_nrnem) v1de their ietter No ................... Dated ........... As directed, you are requei;ted to ensure tr.:at the case {s investigated ;.Ticier provisions of Rule 20 of the Chhattisgarh Scheduled Castes, Scheduled ] ribes 21.,d Orher Ea.ckw~~d Classes (Regulation of Social Stat11s Certification) Rules, 2013, by you in person or tiy Police Ir :pectorrc under you, _and the repmt, containing dear opinion, akmg v.·i:th crigim.~s of aU doeumen.s, stateme:,ts and affidavits of w;tness.::$, is to be submitted to t.J!.ie Committee at the eadiest.
2. You are also directed to ensure> th::J detaits o{ the above investigation are maintained in the register of the. Ceil as per :Fl{}rm 0 -5H of the Rule and ::- copy of the same is to be furnished to this Committee.· Encl.: As above Qlpy Endorsicd to:
Member Secretary OR Vice Chairman High Pov,1er Certification Scrutiny Committee . I. Secretary/Prin~ipal Sec!'etary, Gcwt. of CM1atti.sgarh, Scheduled Tribe and Schedi;;ed Caste Development Depanment, Mzntrataya, Mahanadi Bhavan, New Raipur.
2. Chairman, D!strict Levd Ce.:tificates Verification Comm ittce, District. ..................• Chhattisgarh/Secre~1ryiPrincipal Secretary/Acidtl. Ch1ef Secretary, Govt. of Chhattisgarh, ....................... Department (I,faine of Administrative Department), Mahanadi B;1avan, New Raipur.
Me!Dber Secretary OR Vice Chaiw:,m H:'igh Power Certification Sc:-t:tiny Committee , .
~tih-isr~ m, ~ 2 ~ 2013 788 (~7) Fonn-6B [ see Rufo 22 ( l) J OFFICE OF IDGH POWER CERTIFICATION SCRUTINY COMMITTEE SI No.· ••••••••••.•• To, Shri/Smt./Ku ................................. .
S/o,/D/o,W/o, .............................. .
Resident of. ....................................... .
SHOW CAUSE NOTICE Investigation· of your Social Status Certificate, submitted for inv\!stigation and ~crutiny i.o this Committee by District Level Cenificates Verification Committee.- District ................. ; ., Chhattisgarh / Govt. of Chhattisgarh, ................... (Name of Administrative Department) viue t.:neir letter No ................... Dated ........... , has been conducted by Dy. Supdtt. of Police. Vigilance· Cell (Investigation and Scrutiny of Social Status). As per the report of Dy. Supdtt. of Police, your Social Status Certificate is false and fraudulently obtained.
2. Therefore, in exercise of powers conferred by Section 15 of Chhattisgarh Scheduled Castes, Schr,dulerJ Tr!be~ and Other Backward Classes (Regulation of Social Status Certification) Act, 2013, .and .1s prescdbed in Rule 22 of the Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (regulation of Social Status Certification) Rules, 2013, this Committee has made the penultimate decision tn investigate your claimed Social Status Certificate on the basis. of investigation -rei)Ort submitted by the Dy. Supdtt. of Police of Vigilance Cell (Social Status Investigation and Scrutiny Comm1ttee);.Raipur.
3. The investigation report and the copy of statement of relevant witnesses and other documents submitted by the Dy. Supdtt. of Police of Vigilance Cell (Social Status Investigation and Scrutiny Committee), ~aipur are enclosed herewith. You are directed to submit your clarification in .this regard within -15 days from the date of receipt of this letter and say:
1. Whether you Jlesire a Personal Hearing.
2. Whether you desire an Oral Enquiry
3. If you desire to produce any witness md documents- in support of your· Social Starus~ if yes, · submit li~t.
4. · You· are also informed that if your clarification. in this regard is not received by this Committee within the above mentioned period; it shall be assumed that yuu have nothing t.o say in·this regard and one-sided action shall be taken.against.you.
Encl.: As above ·Member-Secretary 6R Vice Chairman High Power Certification Scrutiny Committee Form-6C [ see Rule 22 (5) ] · OFFICE OF IDGH POWER CERTIFICATION SCRUfINY COMMITTEE SI NO ........... -,r; •• Date .......... .
To, TehsikJa.r/ Addi. Tehsildar/ Nayab TehsiJdar Sub.: Public notice about Investigation and Scrutiny of Social Status of Shri/Smt./Ku ..................................... , Sio/D/o,W/o, .............. ·····•,·.······· ... , resident of ........... : ......... , by beating of Dmm - reg.
The investigation and scrutiny of the Social Status Claim of Shri/SmtJKu .. , .................................. , S/o,!D/o,W/o, .................... , .......... , resident of .................... .
is being done by this Committee, in exercise of powers conferred by Section 15 of Chhattisgath Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Acl 2013, and as prescribed in Rale 22 of the Chlrnttisgarh Scheduled Castes, Scheduled Tribes and Othc:r Backward Clas~es (Regutation of Social Status Certification) Rules, 2013.
2. If any pcn:-0n or institution from the present, erstwhile or permanent residence of · Shri/Smt./Ku .................. , .................. , S/oJD/o,W lo, .................. ": ............ , resident of .................... -~ wishes to support or oppose the Social Status Claim of the applicant, it may do so.
3. Therefore, a public notice m.:.Ay be circulated by way of pasting written notice or by beating drum in the context ot the above enquiry of Shri/Smt./Ku ............... · ...................... , S/oJDlo,.W lo, . ...................... .' ........ , resjdcnt of. .................... , in ·············.···············<narile· of ViHage/Mohalla/ Area) that if any resident or institution or any other person of the area who has knowiedge of the Sodal Status of Shri/Smt./Ku ... : ................................. , S/o/0/o,W/o, .~ ............................. , resident of ...... ·····:·········· may appear before the Committee on ................ (Date) ................ (Hour) ......... (Place) and may prorluce. oral statement or affidavit any relevant document.
Member Secretary OR Vice Chairman High Power Certifi~aii'on'S~rutiny Cpmmittee · __ 788 (89) Form-7A · [ see Rule 27 (2)1 Progress report regarding issuance of Social Status Certificate or rejection of application Name of Distdct Year20 .....
SI. Name of Month No. of No. of No of Total Noof Noof Noof Noof Sub Application pending Appli- Certificat rejected Certi- Appli-:- Division s received Applications cations es issued Appli- ficates cations during the for the (3+4) during cations forwarded pending Month previous the to District at the end Months month • Veri- of the I fication month Committe· i ,.
e I 2 3 4 5 6 7 ! 8 9 10 Fonn-7B [ see Rule 27 (3) 1 :, •·Progress report regarding verification of Social Status Certificate, re_jection or forwarding of application to the Scrutiny Committee Name of Distdct Year 20 .....
SI. Month Noof Noof No. of Noof Noof Noof Noof Noof Appli- Appli- .pending Total Certi- . rejected Certi- Application/ cations/ · Appli- Appli- ficates Appli- ficates cations Certi- Complaints cations cations verified cations · forward- pending at ficates received for the (3+4) during ded to the end of received from non- prev10us the month Scrutiny the month from Sub applicants Months Committee Division ..... , ,.., ... {'t ,..t-,1 j Officers I 2 3 . ~ ·-- 4 5 6 7 8 9 IO =78=8=(=90:::)==:::::::====~:::::::::==:===:=::0::::m:::~~.-'l::::~=(=l~=q:::7t'=:=f<:::~1=icfi==2=fu=-(:tki~{~2~0;13~==========::::::::::::::=:::::::==== - -~ .. -- , - ~ ,, Form7C f see Rule 27 (4)] Progress report regarding dispo8al. of S{)dal Status Certificate and Complaints received regarding them Name of District Year 20 .....
-----.-----,-----..------,r---~----,-------,-------r-----, SI. Month j No of ) No of I No. of No of I No of I i Cases I Case~ pending Total I Cases i rece,vf.'d I r.ece:1ved I Cas.;.s for Cru;es I disposed from I from I the I (3+4) ! during · I Si.ate I Veri- I previou~ 1 I the i Govem I f:ca.tion i'\,fonths I I month 1 ment : Commit l ! during ' tees j the j I , momh I I I '.2 I 3 I 4 I 5 6 1 7 Noof rejected Certificates 8 No of Cases pending at the end of the month 9 Remarks _ _,.
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