various dates mentioned in this document are in accordance...

Various dates mentioned in this Document are in accordance with the schedule notified by JoSAA/CSAB-2019. In case of change in schedule to be notified by JoSAA/CSAB-2019, these dates will be revised accordingly. Candidates are advised to visit JoSAA-2019 and CSAB-2019 website for latest update.

https://josaa.nic.in/

https://csab.nic.in/

National Institute of Technology Hamirpur (H.P.)

Provisional Registration Slip (B.Tech./B.Arch./Dual Degree)

Entry No: /2019 Mr/Ms ______________________________________________________

Roll No: _______________________ S/oD/o _____________________________________________________

Department: ___________________ Section/Group: _______________________________________________

Date of Registration in the Institution: __________ July, 2019

Documents to be submitted (if any): _______________________________________________________________

____________________________________________________________________________________________

Admission/Registration is Provisional subject to submission of above document(s) by 15.09.2019.

Classes shall commence from 25.07.2019.

Deputy Registrar (Academic) or His Nominee


Provisional Registration Slip (B.Tech./B.Arch./Dual Degree)

Entry No: /2019 Mr/Ms ______________________________________________________

Roll No: _______________________ S/oD/o _____________________________________________________

Department: ___________________ Section/Group: _______________________________________________

Date of Registration in the Institution: __________ July, 2019

Documents to be submitted (if any): _______________________________________________________________

____________________________________________________________________________________________

Admission/Registration is Provisional subject to submission of above document(s) by 15.09.2019.

Classes shall commence from 25.07.2019.


Token Number: Date:


Application Form for Registration

To The Deputy Registrar (Academic) NIT Hamirpur (HP) Sir, Kindly allow my registration in First Semester (2019-20) as per following details: Department ____________________________________________________ Programme (B.Tech./B.Arch./Dual Degree) ____________________________________________________ Branch ____________________________________________________ Roll No. ____________________________________________________ Name: Mr / Ms ______________________________________________________________________ (in English)

नाम: श्री / सुश्री ______________________________________________________________________

(ह िंदी में)

Father’s Name: ______________________________________________________________________ Address for Correspondence (in Capital Letters) Permanent Address (in Capital Letters)

PIN Code: Mobile: PIN Code: Mobile:

Yours faithfully, Signature of the Student

For Official Use

Registration Number: (to be assigned by the Academic Branch)


Registration Card of the Concerned Branch

National Institute of Technology Hamirpur (H.P.) B.Tech./B.Arch./Dual Degree Admissions, July 2019

Document Verification Form

Affix Passport Size Photograph

Name: __________________________________________ JEE(Main) Application Number: ______________ Category: OP/EWS/SC/ST/OBC Whether PwD: Yes/No Entry Number: _________________

Note: Each candidate is required to produce one set of documents/certificates alongwith other credentials given below. A

candidate will not be allowed admission if he/she fails to produce original documents/certificates for verification. Formats of

various certificates/affidavits alongwith pertaining instructions are available on the Institute/JoSAA website and candidates are

advised to follow the same.

SNo Details of Documents/Certificates Y N NA

1. Provisional Admission Letter issued from JoSAA-2019 with Upgradation Letter (Original)

2. Three Number of Passport Size Colored Photographs (Identical to one Uploaded during JEE (Main) 2019

Registration)

3. Admit Card of JEE (Main) 2019 (Self Attested)

4. Score Card of JEE (Main) 2019 [Downloaded from JEE (Main) Portal] (Self Attested)

5. Mark Sheet/Certificate of Class X (High School) [as Date of Birth proof ] (Self Attested)

6.

Mark Sheet and Pass Certificate of Class XII [as proof of (i) Sate of Eligibility (ii) Percentage of Marks]

(Self Attested) (Note: (a) Indian nationals who passed the qualifying examination from Nepal/Bhutan or an institution abroad must bring passport. Permanent

address given in the passport will determine the State of Eligibility. (b) Candidates having Senior Secondary Certificate from National Open

School must bring the proof of place of examination centre of the final examination to determine the State of Eligibility.)

7. Conduct/Character Certificate from Head of Institution Last Attended (Self Attested)

8. Migration/Transfer Certificate (Original)

9. Photo ID Proof (Issued by Govt. Agency/Last Attended School/Class XII Admit Card) (Self Attested)

10. Valid Category Certificate (OBC/SC/ST) on JoSAA-2019 format [OBC-NCL Certificate must be issued on

or after April 01, 2019] (Self Attested) (Note: The caste of the candidate must be in the state-wise central list)

11. OBC-NCL Undertaking in JoSAA-2019 Format (for OBC-NCL Candidates only) (Original)

12. Income and Asset Certificate Issued by Competent Authority (for EWS Candidates only) on

JoSAA-2019 Format (must be issued on or after April 01, 2019 for Financial Year 2018-19) (Self Attested)

13. Medical Fitness Certificate issued by the Medical Officer, NIT Hamirpur Health Centre or any

Government Civil Hospital (Original)

14. Certificate of Persons with Disability (for PwD Candidates Only) on JoSAA-2019 Format (Original) (Note: The certificate will be rejected if the disability is less than 40%)

15.

Income Certificate issued by States/UTs designated authorities at District/Sub-District/Block, etc.

Level for Economic Backward Class (EBC) for claiming exemption in Tuition Fee based upon Annul

Income less than `5.0 Lac (Original) (Note: Income Certificate from designated authority as per list enclosed for concerned State/UT issued on/after April 01, 2019 for Financial

Year 2018-19 is required)

16. An Undertaking by the Student - Institutional (in the given format) (Original)

Affidavits

17. Affidavit (on stamp paper of `10 denomination in the given format) for giving reason for study gap (if

any) duly signed by Oath Commissioner/Notary Public/Executive Magistrate (Original)

18. An Affidavit by the Student [Anti-ragging Measures generated online at antiragging.in] [two copies-one for Institute and other

for Hostel] (Original)

antiragging.in

antiragging.in

19.

An Affidavit by Parent/Guardian [Anti-ragging Measures generated online at antiragging.in] [two copies-one for Institute and

other for Hostel] (Original)

Fee (Institute and Hostel)

20.

(a) Remaining Institute Semester Fee

The Remaining Institute Semester Fee is to be paid through SBI Collect (as per the mentioned procedure) and Payment

Receipt (Original) is to be submitted at the time of Physical Reporting/Registration.

GOI has allowed Fee Waiver in tuition fee to SC/ST & PwD candidates. There is also Fee Waiver in tuition fee to Open and

OBC candidates based on annual income of the family subject to the production of latest valid Income Certificate issued by the

competent authority as per details given at SNo 15.

Description Open/

OBC

(`)

SC/ST &

PwD

(`)

Open/OBC

(Annual Income less than

`1.00 Lac)

(`)

Open/OBC

(Annual Income between `1.00

to `5.00 Lac)

(`)

Total Fee 78,900 16,400 16,400 37,233

Fee paid to JoSAA 35,000 15,000 35,000 35,000

Remaining Fee 43,900 1,400 -- 2,233

(Note: Candidates belonging to ST Category are advised to adhere to the instructions issued by MHRD vide No.33-1/2019-

TS-lll Dated 27.03.2019 [copy attached] regarding Fee Waiver.)

(b) Hostel Fee is to be paid through DD payable at SBI, NIT Hamirpur. DD is to be submitted in concerned Hostel at the time

of Hostel Allotment.

Boys `25,900 DD in favour of Warden, Kailash Boys Hostel, NIT Hamirpur

Girls `25,900 DD in favour of Warden, Ambika Girls Hostel, NIT Hamirpur

Note: 1. If the original documents/certificates are not in English/Hindi, duly certified English/Hindi

version/translation of such documents/certificates shall be required during verification.

2. Admission/Registration is Provisional subject to submission of above document(s) by 15.09.2019.

3. Regular classes shall commence from 25.07.2019.

I hereby declare that the above statements are correct. In case I fail to submit the remaining documents by the specified deadline,

I shall accept the Institute decision for seat cancellation and forego my claim on the admission.

Signature of the Student The above documents have been verified with the originals.

The documents/proofs at SNo ___________________________ is/are not produced and he/she may be allowed provisional admission/registration subject to the production of these documents by the specified deadline.

Document Verifying Officer (1) Document Verifying Officer (2) Deputy Registrar (Academic) or His Nominee

National Institute of Technology Hamirpur (H.P.) Data Sheet (Session 2019-20)

Date __ __/__ __/2019 Entry Number: /2019 Roll Number: ________________

Name (in English):

Name (in Hindi):

Email:

Date of Birth:

D D M M Y Y Y Y

Religion: Gender: Main Category: (OP/OPPwD/EWS/EWSPwD/SC/SCPwD/ST/STPwD/OBC/OBCPwD)

Student’s Mobile Number: Student’s Aadhar Number:

You Belong to Urban Area / Rural Area (tick appropriate) Country: State:

Correspondence

Address

PIN:

Permanent Address

PIN:

Nearest Railway Station:

JEE(Main) Application No: JEE(Main) Percentile: JEE(Main) Rank-CRL:

JEE (Main) Category-Category: Admitted Category: (OP/OPPwD/EWS/EWSPwD/SC/SCPwD/ST/STPwD/OBC/OBCPwD)

Country from where 10+2 Passed: State from where 10+2 Passed:

(i.e. state of Eligibility for JEE(Main))

10+2 Percentage: 10+2 Year of Passing: Type of School: Govt / Private

(tick appropriate)

School in Urban Area / Rural Area

(tick appropriate)

Name of 10+2 School: 10+2 Board:

UG Programme: B.Tech. / B.Arch. / Dual Degree

(tick appropriate)

Branch

(tick appropriate)

Architecture Chemical Engineering Civil Engineering Computer Science & Engineering Electronics & Communication Engineering Electrical Engineering Mechanical Engineering Materials Science & Engineering

Hostler: Yes /No (tick appropriate) Hostel Name (tick appropriate): Kailash Boys Hostel / Ambika Girls Hostel

Father’s Name: Father’s Mobile: Father’s Email:

Mother’s Name: Mother’s Mobile: Mother’s Email:

Guardian’s Name: Guardian’s Mobile: Guardian’s Email:

Family Income: ` (proof to be attached for EWS/ EBC)

Fee Waiver Claimed:

(tick appropriate)

SC/ST/PwD

Income Less Than `1.0 Lac

Income Between `1.0 Lac and `5.0 Lac

Fees Status

JoSAA-2019 Amount: ` Date:

NIT Hamirpur Amount: ` Date: Receipt No.:

Total Amount: `

Signature of the Student

Guidelines for Payment of Remaining Fee Through SBI Collect

for B.Tech./B.Arch./Dual Degree

1. Goto www.onlinesbi.com and select option State Bank Collect

2. Accept terms & conditions and Proceed further

3. Select State of Corporate/Institute: Himachal Pradesh and Type of Corporate/Institute: Educational

Institute

4. Select Educational Institute Name: NIT Hamirpur and click on Submit

5. Select Payment Gateway B.Tech./B.Arch./Dual Degree (First Sem Only) New and fill the details to

proceed further

Note: Print the Receipt for further record.

Online Generation of Anti Ragging Affidavit Through antiragging.in

Use JEE (Main) Application Number for Registration/Enrolment

Institution Information

Name of Director: Prof. Vinod Yadava

Institute Phone Number: +91 1972 222308 / 224390

Class Wise Number of Students

SNo Class Number of Students

1. B.Tech., Chemical Engineering 76

2. B.Tech., Civil Engineering 121

3. B.Tech., Electrical Engineering 123

4. B.Tech., Computer Science & Engineering 120

5. B.Tech., Electronics & Communication Engineering 116

6. B.Tech., Material Science & Engineering 39

7. B.Tech., Mechanical Engineering 121

8. Dual Degree, Electronics & Communication Engineering 75

9. Dual Degree, Computer Science & Engineering 76

10. B.Arch. 58

antiragging.in

MEDICAL EXAMINATION REPORT

(To be issued by Govt Civil Hospital or NIT Hamirpur Dispensary)

Roll Number: _______________________________ Entry Number: _______________________________

GENERAL EXPECTATIONS

Candidate will have good general physique with

(a) Vision should be normal. In case of defective vision it should be corrected to 6/9 in both eyes or

6/6 in the better eye

(b) Hearing should be normal. Defective hearing should be corrected

(c) Heart and Lungs should not have any abnormality and no history of mental disease or Epileptic fits

PERSONAL HISTORY 1. Name

2. Father/Guardian’s Name

3. Age

Date of Birth

Years _________Months ________

_____________________________

4. Gender

5. Identification Mark on the Body (This can be a mole, scar or birthmark)

6. Major illness/operation (Specify nature of illness/operation)

Declaration by student

I am not suffering from any chronic illness like Epilepsy, Bronchial Asthma, etc.

Signature of the Candidate

MEDICAL CERTIFICATE

(Item 7-19 to be filled by Medical Officer conducting the Medical examination)

7. Height cm.

8. Weight Kg.

9. Past History (a) Mental Disease

(b) Epileptic fit

10. Chest (a) Inspiration cm.

(b) Expiration cm.

11. Vision with or without

glass

(a) Right eye

(b) Left eye

(c) Colour Blindness

12. Hearing

13. Abdomen (a) Liver

(b) Spleen

14. Respiratory system

15. Nervous system

16. Blood Group

17. Heart (a) Sounds

(b) Murmur

18. (i) Hernia

(ii) Hydrocele

19. Any other defects

Certified that Mr/Ms ………………………………….... son/daughter of …………………………………………………

(i) fulfills the prescribed standard of physical fitness and is FIT for admission to engineering/ architecture/

science stream.

(ii) does not fulfill the prescribed standard of physical fitness and is unfit/temporarily unfit for admission due to

following defects: ……….…………………………………………………..

Signature of the Medical Officer

Date: ………………………….

Regn. No.: ………………………..

SEAL

STUDY GAP AFFIDAVIT

I __________________________________ S/D/o ______________________________________

R/o ___________________________________________________________________________

______________________________________________________________________________

Do hereby solemnly and state as under:

1. That my above name and address is correct.

2. That I have passed Class XII from ______________________________________________

in the year ___________ with _______% marks or_____________CGPI.

3. That there is a gap of ___________ year(s) between passing of Class XII and now seeking

admission in National Institute of Technology Hamirpur (HP) .

4. That during this gap period I was doing

__________________________________________________________________________.

5. That during this gap period, I was neither studying anywhere nor passed any other

examination.

6. That I was not involved in any criminal offence whatsoever and I was not punished for any

offence by any Court of law during this gap period.

DEPONENT VERIFICATION

That the above statement is true to the best of my knowledge and belief and nothing has been

concealed there from.

DEPONENT


Permission to Reside as a Day Scholar

To The Dean (SW) NIT Hamirpur (HP) Sir, Kindly grant me permission to reside as Day Scholar outside the NIT Hamirpur Campus: Department ___________________________________________ Programme (B.Tech./B.Arch./Dual Degree) ___________________________________________ Branch ___________________________________________ Roll No. ___________________________________________ Name: Mr / Ms _______________________________________________________________ (in English)

नाम: श्री / सुश्री _______________________________________________________________

(ह िंदी में)

Father’s Name: ______________________________________________________________ Reasons to Stay Outside the Hostel: _____________________________________________

____________________________________________________________________________ Address Where Willing to Stay (in Capital Letters) Permanent Address (in Capital Letters)

PIN Code: Mobile: PIN Code: Mobile of Parents:

Yours faithfully, Signature of the Student

Consent of the Parent/Guardian

For Official Use

Dean (SW) or His Nominee

Forwarded for Permission of Dean (SW)


INCOME CERTIFICATE ISSUING AUTHORITY

SNo States/Union Territory Income Certificate Issuing Authority

1. A and N Island Tehsildar

2. Andhra Pradesh Tehsildar

3. Goa Mamlatdar of all Talukas

4. Gujarat District Collector / Deputy Collector / Asst. Collector / Prant Officer/ Mamlatdar

5. Karnataka Tehsildar

6. Kerala Village Officer not below the rank of BDO

7. Maharashtra Tehsildar

8. Mizoram District magistrate or any other Officer authorized by District Magistrate

9. Pondicherry Tehsildar

10. Rajasthan Tehsildar

11. Tamil Nadu Zonal Deputy Tehsildar

12. Uttar Pradesh Tehsildar

13. Uttarakhand Tehsildar / SDM / City Magistrate

14. Delhi SDM of Govt. of NCT of Delhi

15. Chandigarh Sub Divisional Magistrate

16. Himachal Pradesh Tehsildar of Revenue Department

17. Chhattisgarh NayabTehsildar

18. Madhya Pradesh Tehsildar / NaibTehsildar

19. West Bengal 1. District level – Dist. Magistrate or Addl.Dist. Magistrate 2. Sub-Division level – Concerned Sub-Divisional Officer 3. Block level – Block Development Officer of concerned block 4. Kolkata Municipal Corporation – The Collector, Kolkata

Corporation 5. Other areas covered in Kolkata Police i.e. areas over which

Collector, Kolkata does not exercise jurisdiction – Concerned District Magistrate or any other officer authorized by the District Magistrate of South 24 Paraganas and North 24 Paraganas

20. Jammu & Kashmir Sub-Divisional Magistrate (not below the rank of Tehsildar)

21. Jharkhand Sub-Divisional Officer in each District

22. Meghalaya Employer in case of Government Employee and by the DC/SDO Civil in case of others

23. Daman & Diu and Dadra & Nagar Haveli

Mamlatdar, Daman &Mamlatdar, Diu

24. Haryana CRO (Tehsildar/NaibTehsildar concerned)

25. Punjab CRO (Tehsildar/NaibTehsildar concerned)

26. Nagaland Dy.Commissioners, Addl.Dy.Commissioner and Sub-Divisional Officers(C)

27. Lakshadweep Dy.Collector in Agatti and Minicoy and SDOs in the remaining Islands

28. Assam Revenue Circle Officers

29. Tripura District Magistrate & Collector

30. Arunachal Pradesh Dy.Commissioner of respective Districts

31. Odisha Revenue Officers

32. Bihar Circle Officer from Circle Office

33. Sikkim Special Executive Magistrate (Block Development Officers, Rural Management & Development Department)

34. For all other remaining States and Union Territories

Not below the rank of Tehsildar/Competent Authority as per Govt. Notification

INCOME CERTIFICATE AFFIDAVIT

I ................................................................................. (Name of Father/Mother/Guardian) age

…........ years, Indian inhabitant, residing at .................................................................................

.............................................................................................................. (Full Address) Inform

that my son/daughter ........................................................................ (Name) having been

admitted to NATIONAL INSTITUTE OF TECHNOLOGY HAMIRPUR do hereby state and

declare on solemn affirmation as under:

i) I say my ward is taking admission claiming the tuition fee waiver/remission against

the income certificate bearing No................................ dated .....................submitted

by me duly issued by the competent authority (Authorized by the Government).

ii) I say the certificate submitted by me includes the annual income of all my family

members during the financial year 2018-19.

iii) I say I shall inform NIT Hamirpur in case my income exceeds the prescribed limits of

exemption in tuition fees by GOI.

iv) I hereby solemnly aver and undertake that the above submitted Income Certificate is

true and correct as per the norms of Government. In case the submitted Income

Certificate is found untrue/false at any point of time, I am aware that I have to pay

the full fees with penalty as imposed by the Institute. I am also aware that the

Institute can take any disciplinary action against my ward and that shall be

acceptable to me.

I am making this Affidavit to produce the same before National Institute of Technology Hamirpur to indicate the income certificate submitted for tuition fee exemption/remission for the academic year 2018-19. Date: DEPONENT Place: (Father/Mother/Guardian)

FORMAT OF INCOME CERTIFICATE TO BE ISSUED ON LETTER HEAD OF ISSUING AUTHORITY (FOR ECONOMICALLY BACKWARD CANDIDATES)

INCOME CERTIFICATE FOR THE WAIVER OF TUITION FEE

1. Name of candidate : 2. Date of Birth : 3. Father’s / Mother’s Name : 4. Occupation of Father / Mother : 5. Domicile State : 6. Residential Address : 7. Annual Family Income (in Rs.) :

(in words & figure)

8. Source of Income : 9. Date of issue :

(Signature of issuing authority) Name: Designation: (Stamp of issuing authority)

Note. The following authorities are authorized to issue income certificates for the purpose of

identifying Economically Backward classes.

(i) District Magistrate / Dy. Commissioner / Collector or any other Revenue Officer upto the level of Tehsildar.

(ii) Income Certificate to be issued on letter head of Issuing Authority (for Economically

Backward candidates)

The income and assets of the families as mentioned

would be required to be certified by an officer not

below the rank of Tehsildar in the States/UTs.

FORM-GEN-EWS

Government of ………………………………….

(Name & Address of the authority issuing the certificate)

INCOME & ASSET CERTIFICATE TO BE PRODUCED BY ECONOMICALLY WEAKER

SECTIONS

Certificate No. Date:

VALID FOR THE YEAR _

1. 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 in 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 Schedule Caste, Schedule Tribe and Other Backward Classes (Central List).

Signature with seal of Officer

Name

Designation

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

** Note2: The term “Family” for this purpose include the person, who seeks benefit of reservation, his/her

parents are siblings below the age of 18 years as also his/her spouse and children below the age of 18 years.

*** Note3: 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.

Recent Passport size

attested photograph

of the applicant

No.33-1/2019-TS-lllGovernment of lndia

Ministry of Human Resource DevelopmentDepartment of Higher Education

TechnicalSection-lll

Shastri Bhawan, New Delhi.Dated: 27th March,2019

To

The Directors,All National lnstitute of Technology (NlTs) & llEST, Shibpur

CORRIGENDUM

Sub: Reimbursement of tuition fee for eliqible SC/ST students studvinq inllTs/NlTs - req.

Sir/Madam,

I am directed to refer to this Division's letter of even number dated 7th March,2019 and 27th March ,2019 (copy enclosed) on the subject mentioned above whereinall the National lnstitute of Technology (NlTs) and IIEST Shibpur were requested toadhere the following instructions:

. Top Class Scholarship (TCS): Tuition fee needs to be claimed from MoTA.

. Post Matric Scholarship (PMS): Tuition fee may be claimed from TribalDepartment of the domicile State of the ST students.

. ST students who are not covered under the above scheme could beprovided fee waiver.

2. ln partial modification to the above communication, the following may be readin respect of last bullet point:-

"those cases which are not covered under first two conditions, may beexamined in light of various instructions issued by NlTs Division fromtime to time"

in place of

3.to time.

"Sf sfudents who are not covered under the above scheme could beprovided fee waiver"

All the lnstitutes are requested to adhere to the instructions issued from time

Yoqs faithfully,

t3\Encl.: As above.(Anil Kumar Singh)

Under Secretary to the Govt. of lndiaTele No.: 011-23384897

Copy to: Shri Sanjeev Shrivastava, Under Secretary [C), Ministry of Human

Resource Development w.r.t. their OM No. 13-27l2018-TC (Part ll) dated 22.02.2019,

\\

No. 33-1/2ol e-Ts-il | (r+, U)Government of lndia

Ministry of Human Resource DevelopmentDepartment of Higher Education

Technical Section-lll

Shastri Bhawan, New Delhi.Dated 7/,March,2019

To

The Directors,All National lnstitute of Technology (NlTs) & llEST, Shibpur.

Sub: Reimbursement of tuition fee for eliqible SC/ST students studvinqin llTs/NlTs - req.

Sir/Madam,

I am directed to enclosed herewith a copy of Technical Section(Coordination) letter No. 13-2712018-TC (Part ll) dated 22.02.2019 (copyenclosed) wherein Technical Section has requested to issue the followinginstructions regarding tuition fee reimbursement for ST students who arestudying in llTs/NlTs and are the beneficiaries of the following schemes ofMinistry of Tribal Affairs:

. Top Class Scholarship (TCS): Tuition fee needs to be claimed fromMoTA.

o Post Matric Scholarship (PMS): Tuition fee may be claimed fromTribal Department of the domicile State of the ST students.

. ST students who are not covered under the above scheme could beprovided fee waiver.

2. All NlTs are requested to adhere the above mentioned instructions andtake appropriate action at your end'

yours faithfury,

Encl.: As above.(Anil h)sl

Under Secretary to the Govt. of lndiaTele No.: 011-23384897

Copy to: Shri Sanjeev Shrivastava, Under Secretary (TC), Ministry ofHuman Resource Development w.r.t. their OM No. 13-2712018-TC (Part ll)dated 22.02.2019.

/.\ I

!: -.,f,.-.. - -

FORM-OBC-NCL OBC-NCL Certificate Format

FORM OF CERTIFICATE TO BE PRODUCED BY OTHER BACKWARD

CLASSES (NCL) APPLYING FOR ADMISSION TO CENTRAL EDUCATIONAL

INSTITUTIONS (CEIs), UNDER THE GOVERNMENT OF INDIA

This is to certify that Shri/Smt./Kum* Son/

Daughter* of Shri/Smt.* of Village/

Town* District/Division* in the

State/Union Territory belongs to the

community that is recognized as a backward class under

Government of India**, Ministry of Social Justice and Empowerment’s Resolution No.

dated ***

Shri/Smt./Kum. and/or

his/her family ordinarily reside(s) in the District/Division of

the State/Union Territory. This is also to certify that he/she

does NOT belong to the persons/sections (Creamy Layer) mentioned in Column 3 of the Schedule

to the Government of India, Department of Personnel & Training O.M. No. 36012/22/93- Estt.

(SCT) dated 08/09/93 which is modified vide OM No. 36033/3/2004 Estt.(Res.) dated

09/03/2004, further modified vide OM No. 36033/3/2004-Estt. (Res.) dated 14/10/2008, again

further modified vide OM No.36036/2/2013-Estt (Res) dtd. 30/05/2014.

Dated:

Seal

* Please delete the word(s) which are not applicable. ** As listed in the Annexure (for FORM-OBC-NCL)

District Magistrate /

Deputy Commissioner / Any other Competent Authority

*** The authority issuing the certificate needs to mention the details of Resolution of Government of India, in which the caste of the candidate is mentioned as OBC.

NOTE:

(a) The term ‘Ordinarily resides’ used here will have the same meaning as in Section 20 of the

Representation of the People Act, 1950.

(b) The authorities competent to issue Caste Certificates are indicated below: (i) District Magistrate/ Additional Magistrate/ Collector/ Deputy Commissioner/ Additional Deputy

Commissioner/ Deputy Collector/ Ist Class Stipendiary Magistrate/ Sub-Divisional magistrate/ Taluka Magistrate/ Executive Magistrate/ Extra Assistant Commissioner (not below the rank of Ist Class Stipendiary Magistrate).

(ii) Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.

(iii) Revenue Officer not below the rank of Tehsildar’ and

(iv) Sub-Divisional Officer of the area where the candidate and/or his family resides

ANNEXURE for FORM-OBC-NCL

Sl. No. Resolution No. Date of Notification

1 No.12011/68/93-BCC(C) 13.09.1993

2 No.12011/9/94-BCC 19.10.1994

3 No.12011/7/95-BCC 24.05.1995

4 No.12011/96/94-BCC 09.03.1996

5 No.12011/44/96-BCC 11.12.1996

6 No.12011/13/97-BCC 03.12.1997

7 No.12011/99/94-BCC 11.12.1997

8 No.12011/68/98-BCC 27.10.1999

9 No.12011/88/98-BCC 06.12.1999

10 No.12011/36/99-BCC 04.04.2000

11 No.12011/44/99-BCC 21.09.2000

12 No.12015/9/2000-BCC 06.09.2001

13 No.12011/1/2001-BCC 19.06.2003

14 No.12011/4/2002-BCC 13.01.2004

15 No.12011/9/2004-BCC 16.01.2006

16 No.12011/14/2004-BCC 12.03.2007

17 No.12011/16/2007-BCC 12.10.2007

18 No.12019/6/2005-BCC 30.07.2010

19 No. 12015/2/2007-BCC 18.08.2010

20 No.12015/15/2008-BCC 16.06.2011

21 No.12015/13/2010-BC-II 08.12.2011

22 No.12015/5/2011-BC-II 17.02.2014

FORMAT FOR DECLARATION TO BE SUBMITTED BY OBC CANDIDATES

I, ____________________________________________________________, son/daughter of

Shri ____________________________________ resident of village/town/city _______________

district ________________ of State/UT _________________________hereby declare that I belong

to the __________________________ community which is recognised as a backward class by the

Government of India for the purpose of reservation in services as per orders contained in Department

of Personnel and Training Office Memorandum No.36012/22/93- Estt. (SCT), dated 8/9/1993. It is also

declared that I do not belong to persons/sections (Creamy Layer) mentioned in Column 3 of the

Schedule to the above referred Office Memorandum, dated 8/9/1993, which is modified vide

Department of Personnel and Training Office Memorandum No.36033/3/2004 Estt.(Res.) dated

9/3/2004. I also declare that the condition of status/annual income for creamy layer of my

parents/guardian is within prescribed limits as on financial year ending on March 31, 2019.

Place: __________________________

Date: ________________

___________________________

Signature of the Candidate

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FORM-SC/ST

SC/ST Certificate Format

FORM OF CERTIFICATE TO BE PRODUCED BY SCHEDULED CASTES (SC) AND SCHEDULED TRIBES (ST) CANDIDATES

1. This is to certify that Shri/ Shirmati/ Kumari* son/daughter*

of of Village/Town* _ __

District/Division* _ of State/Union Territory* belongs to

the Scheduled Caste / Scheduled Tribe* under :-

* The Constitution (Scheduled Castes) Order, 1950

* The Constitution (Scheduled Tribes) Order, 1950

* The Constitution (Scheduled Castes) (Union Territories) Order, 1951

* The Constitution (Scheduled Tribes) (Union Territories) Order, 1951

[As amended by the Scheduled Castes and Scheduled Tribes Lists (Modification Order) 1956, the Bombay Reorganisation Act, 1960, the Punjab Reorganisation Act, 1966, the State of Himachal Pradesh Act, 1970, the North Eastern Areas (Reorganisation) Act, 1971, the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 1976 and the Scheduled Castes and Scheduled Tribes Orders (Amendment) Act, 2002]

* The Constitution (Jammu and Kashmir) Scheduled Castes Order, 1956;

* The Constitution (Andaman and Nicobar Islands) Scheduled Tribes Order, 1959, as amended by the Scheduled Castes and Scheduled Tribes Order (Amendment) Act, 1976;

* The Constitution (Dadara and Nagar Haveli) Scheduled Castes Order, 1962;

* The Constitution (Dadara and Nagar Haveli) Scheduled Tribes Order, 1962;

* The Constitution (Pondicherry) Scheduled Castes Order, 1964;

* The Constitution (Uttar Pradesh) Scheduled Tribes Order, 1967;

* The Constitution (Goa, Daman and Diu) Scheduled Castes Order, 1968;

* The Constitution (Goa, Daman and Diu) Scheduled Tribes Order, 1968;

* The Constitution (Nagaland) Scheduled Tribes Order, 1970;

* The Constitution (Sikkim) Scheduled Castes Order, 1978;

* The Constitution (Sikkim) Scheduled Tribes Order, 1978;

* The Constitution (Jammu and Kashmir) Scheduled Tribes Order, 1989;

* The Constitution (Scheduled Castes) Order (Amendment) Act, 1990;

* The Constitution (Scheduled Tribes) Order (Amendment) Act, 1991;

* The Constitution (Scheduled Tribes) Order (Second Amendment) Act, 1991.

2. # This certificate is issued on the basis of the Scheduled Castes / Scheduled Tribes* Certificate issued to Shri /Shrimati*

father/mother* of Shri /Shrimati /Kumari* of Village/Town*

in District/Division* _ _ of the State State/Union

Territory* who belong to the Caste / Tribe* which is recognised as a Scheduled Caste /

Scheduled Tribe* in the State / Union Territory*

_ ___ __ ____.

____________________issued by the _ dated

3. Shri/ Shrimati/ Kumari * and / or* his / her* family ordinarily reside(s)** in Village/Town*

of District/Division* of the State Union Territory* of .

Place:

State/Union Territory*

Signature:

Designation

(with seal of the Office)

Date:

* Please delete the word(s) which are not applicable. # Applicable in the case of SC/ST Persons who have migrated from another State/UT. IMPORTANT NOTES

The term “ordinarily reside(s)**” used here will have the same meaning as in Section 20 of the Representation of the People Act, 1950. Officers

competent to issue Caste/Tribe certificates:

1. District Magistrate / Additional District Magistrate / Collector / Deputy Commissioner / Additional Deputy Commissioner / Deputy Collector / Ist Class

Stipendiary Magistrate / City Magistrate / Sub-Divisional Magistrate / Taluka Magistrate / Executive Magistrate / Extra Assistant Commissioner.

2. Chief Presidency Magistrate / Additional Chief Presidency Magistrate / Presidency Magistrate.

3. Revenue Officers not below the rank of Tehsildar.

4. Sub-divisional Officer of the area where the candidate and/ or his family normally reside(s).

5. Administrator / Secretary to Administrator / Development Officer (Lakshdweep Island).

6. Certificate issued by any other authority will be rejected.