APPENDIX-V FORM OF CERTIFICATE TO BE PRODUCED BY A CANDIDATE BELONGING TO A BACKWARD CLASS IN SUPPORT OF HIS CLAIM FORM OF CERTIFICATE OF BACKWARD CLASS i. This is to certify that Mr. _______________________ son of Sh. _____________________ village/Town __________________________ in district/Division ______________________ of the state of Punjab belongs to the_________________________ caste which is recoganised as a Backward Class in the terms of Punjab Govt. Letter no ____________________Dated__________ ii. This is also certified that income of the family from all the sources does not exceed Rs. __________________________ (in words Rupees ____________________________________________________________) iii. Mr ________________________________ and his family ordinarily reside(s) in village/Town _____________________ of district/division _______________________ of the state of Punjab. Place: Signature:_____________ Designation___________ (with seal of office) State: Date: Verified and attested SDO C /Executive Magistrate/ Tehsildar/ Naib Tehsildar /B.D.O Deponent District Revenue officer Father/Guardian This Certificate must not be dated one year before the first day of counseling for admission. A certificate issued more than one year before counseling date shall not be valid. Column (ii) of this certificate must be filled both in figures and words.
