Form of Certificate to be produced by OBClapplying for appointment in posts under the Government of India.

A N N E X U R E –A
Form of Certificate to be produced by Other Backward Classes applying for appointment in posts under the Government of India.
This is to certify that ------------------------------------------------------- Son of............................................................. village-------------------..............District/Division-----------------------------------------------------------------------------in the------------------------------------State-----------------------belongs to the................................................................... --------------------------------------------------------------------------------which is recognised as a backward Class under the Government of India Ministry of Welfare Resolution No. 12011/7/95-BCC dated 24^th May, 1995 published in the Gazettee of India Extraordinary Part I Section I dated........------------....................... .Shri -------------------------------------------------------------------------------------------........and/or his family ordinarily reside (s) in the ---------------------------------------------------------------------------................ District/Division of the ----------------------------------State.
2. 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 Govern- ment of India, Department of Personnel & Training O.M. No. 36012/22/93-Estt (SCT) dated 8-9-1993.
	District Magistrate, Deputy Commissioner etc. Dated Seal

NB (a) The term 'ordinarily' used here will have the same meaning as in Section 20 of the Representation of the Peoples Act, 1950. (b) Where the certificates are issued by Gazetted Officers of the Union Govern- ment or State Governments, they should be in the same form but counter- signed by the District Magistrate or Deputy Commissioner (Certificate issued by Gazetted Officers and attested by District Magistrate/Deputy Commissioners are not sufficient).