Hasina Khatun has applied for an OBC certificate from the Sub-Divisional Officer of Kolkata. She is applying under the category of OBC-A for the Muslim Penchi caste. She provides her personal details including date of birth, place of birth, address, contact information, and Aadhar number. She notes that her brother Fitu SK already possesses a caste certificate. She lists Sirajdulla SK and Tarik Islam as references. Finally, she indicates that neither she nor her family have migrated from another state or country.
Hasina Khatun has applied for an OBC certificate from the Sub-Divisional Officer of Kolkata. She is applying under the category of OBC-A for the Muslim Penchi caste. She provides her personal details including date of birth, place of birth, address, contact information, and Aadhar number. She notes that her brother Fitu SK already possesses a caste certificate. She lists Sirajdulla SK and Tarik Islam as references. Finally, she indicates that neither she nor her family have migrated from another state or country.
Hasina Khatun has applied for an OBC certificate from the Sub-Divisional Officer of Kolkata. She is applying under the category of OBC-A for the Muslim Penchi caste. She provides her personal details including date of birth, place of birth, address, contact information, and Aadhar number. She notes that her brother Fitu SK already possesses a caste certificate. She lists Sirajdulla SK and Tarik Islam as references. Finally, she indicates that neither she nor her family have migrated from another state or country.
Hasina Khatun has applied for an OBC certificate from the Sub-Divisional Officer of Kolkata. She is applying under the category of OBC-A for the Muslim Penchi caste. She provides her personal details including date of birth, place of birth, address, contact information, and Aadhar number. She notes that her brother Fitu SK already possesses a caste certificate. She lists Sirajdulla SK and Tarik Islam as references. Finally, she indicates that neither she nor her family have migrated from another state or country.
FORM OF ON LINE APPLICATION FOR OTHER BACKWORD CLASS To The Sub-Divisional Officer / D.W.O, Kolkata & Ex-Officio Joint Director, B.C.W, Jangipur , Murshidabad. Sir, I do hereby apply for OBC Certificate in the following prescribed proforma, for which particulars are given below. I hereby undertake that the information is correct to the best of my knowledge and belief and if anything found contrary I would be liable for that.
Yours faithfully, Date: (Signature of applicant / gurdian in case of minor) Application No : OBCWB07022023/9069 ( Block : Suti-II ) 1. (a) Applying for : OBC-A (b) Name of caste : Muslim Penchi 2. Full Name of Applicant : HASINA KHATUN : Father's Name 3. : HALIM SK 5. Contact No. : 9775891873 4. (a) Date of Birth : 20/05/2010 6. Email Id. : (b) Place of Birth : 7. Adhar No. : XXXXXXXX3181 Village / Ward Police Station District State NATUN KHANABARI SUTI MURSHIDABAD WEST BENGAL
8. Address since birth (a) Present address:
Para / House No. / Ward No. / G.P. Post Office Police Station District State PIN Road / Village HOQUESAHEB AURANGABAD DAHARPAR SUTI MURSHIDABAD WEST 742201 PARA BENGAL (b) Other address(s) : Para / House No. / Road / Village Ward No. / G.P. Post Office District State PIN HOQUESAHEB PARA AURANGABAD DAHARPAR MURSHIDABAD WEST 742201 BENGAL
9. Nationality : INDIAN 10. Religion : Islam 11. Sex : Female
12. Whether any of the blood relations of the applicant posseses Caste Certificate? No If answer to point no. 12 is 'Yes': Name of cert. holder Relation with applicant Certificate No. Date of Issue Issuing authority FITU SK REAL BROTHER 39757 06/03/2013 JANGIPUR
13. Details of two(2) referees:
Name of 1st referee Address of 1st referee Name of 2nd referee Address of 2nd referee SIRAJDULLA SK NATUN KHANABARI TARIK ISLAM NATUN KHANABARI
14. Whether the applicant or his family migrated from other State / Country? No If point no. 14 is 'Yes': Migration Certificate No. : Date of Issue : Address of the applicant in his/her state of origin. Village / Ward Police Station District State Country Year
Date: ( Signarure of applicant / gurdian in case of minor )
