12842406075002444991
FORM 8
[Rule No. 5(6)]
Form of Caste Certificate for DeNotified Tribe (Vimukt Jati)/Nomadic Tribe/Other Backward
Class/Special Backward Category person belonging to the State of Maharashtra
Documents Verified
1. Application in form B of Dated
2. Affidavit
3. Caste Certificate of the Father
4. Copy of Ration Card
5. School Leaving Certificate
6. Gazette Notification copy
7. Caste Certificate Of Uncle
8. Copy of School Leaving Certificate Of Uncle
9. Copy of School Leaving Certificate Of Grandfather
10. Copy of School Leaving Certificate Of Father
11. Copy of Aadhar Card
CASTE CERTIFICATE
Outward No : 41915179510 Application Date : 07/06/2024
Rev Case No : MRC : 41915179510
This is to certify that Kumari Samiksha Pravin Gosavi Son of Shri Praveen Sudhakar Puri , of
Village Lonavala (M Cl), Tehsil Mawal, in the District Pune of the State of Maharashtra belongs to
the GOSAVI Caste which is recognised as Nomadic Tribe(B) at [Link] 1 under Government
Resolution CBC1361M dated 21/11/1961 as amended from time to time.
Kumari Samiksha Pravin Gosavi and / or his family ordinarily resides in village Lonavala (M Cl),
Tehsil Mawal, in the District Pune of the State of Maharashtra.
Digitally Signed By Surendra Sopan Navale
(District Collector Office Pune)
Date : 11-Jun-2024 14:11:48 IST
Place : Mawal Sub Divisional Officer
Date : 11/06/2024 (With the seal of Office) MavalMulshi
Printed By OMTID :MH032200517 VLE Name :Suryakant Pandurang Aher, Date:11/06/2024 2:11PM
This is a digitally signed document, hence is legally valid as per the Information Technology (IT) Act, 2000.
To verify visit [Link] OR SMS “MH<space>CSC<space>VRFY<20 digit Barcode number>” to 166 from a BSNL, MTNL, Tata Mobile and
51969 from others.