Karnataka EWS Certificate Application Form PDF

Karnataka EWS Certificate Application Form PDF Download

Application Form for EWS Certificate for Government Jobs

Application Form for EWS Certificate for Government Jobs Word, and PDF

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Annexure-I

Government of ___________

(Name & Address of the authority issuing the certificate)

INCOME & ASSEST CERTIFICATE TO BE PRODUCED BY ECONOMICALLY WEAKER SECTIONS
Certificate No._____________

Date:__________________

VALID FOR THE YEAR_____________

This is to certify that Shri/ Smt/ Kumari______________son/ daughter/ wife of______________________ permanent resident of _________________________________________________________ Village /Street ________________________ _____________________Post Office____________ District________________ in the State / Union Territory__________________ Pin Code____________ whose photograph is attested below belongs to Economically Weaker Sections, since the gross annual income* of his / her ‘family”** is below Rs. 8 lakh (Rupees Eight Lakh only) for the financial year _____________. His/her family does not own or possess any of the following assets***:

I. 5 acres of agricultural land and above;

II. Residential flat of 1000 sq. ft. and above;

III. Residential plot of 100 sq. yards and above in notified municipalities;

IV. Residential plot of 200 sq. yards and above in areas other than the notified municipalities.

2. Shri / Smt. / Kumari__________________________belongs to the___________________ caste which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward Classes (Central List)

Signature with seal of Office__________________

Name    _______________________________

Designation_____________________________

Recent Passport size attested photograph of the applicant

*Note1:. Income covered all sources i.e. salary, agriculture, business, profession, etc.

**Note 2:The term “Family” for this purpose include the person, who seeks benefit of reservation, his / her parents and siblings below the age of 18 years as also his / her spouse and children below the age of 18 years

***Note 3: The property held by a “Family” in different locations or different places/cities have been clubbed while applying the land or property holding test to determine EWS status.