FORM NO.
I
(See Rule 3)
GOVERNMENT OF ODISHA
Office of the Tahasildar Koksara
Miscellaneous Certificate Case No E-STO/2022/718780
SCHEDULED TRIBE CERTIFICATE
This is to certify that Miss RENUKA DALAI daughter of Smt PADMA DALAI and Shri RIKHIRAM
DALAI of village/town GOTAMUNDA P.S AMPANI in the KALAHANDI district in the state of Odisha
belongs to Bhunjia caste which is recognized as Scheduled Tribe under the constitution (scheduled
Caste / Scheduled Tribe) order 1950 as amended by the scheduled Caste and Scheduled Tribe List
(Modification) order 1956 and Scheduled Caste and Scheduled Tribe Order (Amendment) Act, 1976.
Miss RENUKA DALAI and her family ordinarily reside(s) in village/town GOTAMUNDA P.S. AMPANI
Tahasil Koksara in the district of KALAHANDI in the state of Odisha.
dgSign2031LocnDyna
Signature of the Revenue Officer
19/12/2022
**** This is a Digitally Signed Document And Does Not Require Signature ****
NOTE
(i) It is a digitally signed electronically generated certificate and therefore needs no ink-signed signature.
(ii) This Certificate is issued as per section 4, 5,& 6 of Information Technology Act 2000 and its subsequent amendments in
2008 and as per Revenue & Disaster Management Department Notification number IMU-13/10-4251/R&DM.
(iii) For any Query or Verification , Agency /Department / Office may visithttps://edistrict.odisha.gov.in
(iv) Tampering of this Certificate will attract penal action.
Reference No: E-STO/2022/718780 To View: https://edistrict.odisha.gov.in/t/2JbYc/6B55DD30 Token No: 6B55DD30