APPLICATION FOR ISSUING OF SCHEDULED TRIBE CERTIFICATE

Office where the Application has to process

Select the office where the Application has to Process *

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District Office *

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ADC Office *

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SDO Office *

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EAC Office *

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CO Office *

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Applicant Details

Salutation of Applicant *

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1. Name of Applicant *

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Salutation of Person *

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2. Name of person for whom certificate is required *

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Photograph for whom certificate is required *

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Salutation of Father *

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3. Father's Name *

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4. Father's Tribe(as per Govement Gazette) *

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Salutation of Mother *

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5. Mother's Name *

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6. Mother's Tribe(as per Govement Gazette)

Date of Birth *

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Relationship of Applicant (Sl. No.1) with Person at Sl. No. 2 *

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Tribe(Other's)

Contact No. *

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E-Mail *

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Are you located at ? *

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Rural

Urban

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Applicant's Address Details

8. Permanent Address

Village / Sector / Colony *

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Post Office *

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Police Station *

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State *

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District *

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Circle *

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Hide label

If present address is same as above

9. Present Address

Village / Sector / Colony *

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Post Office *

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Police Station *

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State *

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District *

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Circle *

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Is Surrender?

Circle present *

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Previous ST No.: *

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Dated *

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Circle permanent *

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Declaration

1. I do hereby declare that the above particulars are true and correct to the best of my knowledge and belief and in case of any false statement / information shall be liable for any action under appropriate section of law.

2. I Shall be liable for punishment as per law in force in the event of finding any of my statement as false in course of time

I Agree *