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Annexure-V
FORMAT FOR SC/ST CERTIFICATE
A candidate who claims to belong to one of the Scheduled Caste or the Scheduled Tribes should
submit in support of his claim an attested/certified copy of a certificate in the form given below, from
the District Officer or the sub-Divisional Officer or any other officer as indicated below of the District
in which his parents (or surviving parent) ordinarily reside who has been designated by the State
Government concerned as competent to issue such a certificate. If both his parents are dead, the
officer signing the certificate should be of the district in which the candidate himself ordinarily
resides otherwise than for the purpose of his own education.
(The Form of the certificate to be produced by Scheduled Castes and Scheduled Tribes
candidates applying for appointment to posts under Government of India)
This is to certify that Shri/Shrimati/Kumari* __________________________ son/daughter of
___________________________________ of village/town/* ___________________________ in District/Division
*_______________________ of the State/Union Territory* __________________belongs to the
Caste/Tribes_______________ which is recognized as a Scheduled Castes/Scheduled Tribes* 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 Re-organisation Act, 1960 the Punjab Re-organisation Act, 1966, the State of Himachal
Pradesh Act 1970 and the North-Eastern Area(Re-organisation) Act, 1971 and the Scheduled Castes
and Scheduled Tribes Order, (Amendment) Act, 1976)
The Constitution (Jammu & 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 (Dadra and Nagar Haveli) Scheduled Castes order 1962@ The Constitution (Dadra
and Nagar Haveli) Scheduled Tribes Order 1962@
The Constitution (Puducherry) Scheduled Castes Order 1964@
The Constitution (Scheduled Tribes) (Uttar Pradesh) Order, 1967 @
The Constitution (Goa, Daman & Diu) Scheduled Castes Order, 1968@
The Constitution (Goa, Daman & 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 & Kashmir) Scheduled Tribes Order 1989@27
The Constitution (SC) orders (Amendment) Act, 1990@
The Constitution (ST) orders (Amendment) Ordinance 1991@
The Constitution (ST) orders (Second Amendment) Act, 991@
The Constitution (ST) orders (Amendment) Ordinance 1996.
The Scheduled Caste and Scheduled Tribes Orders(Amendment)Act,2002
The Constitution (Scheduled Caste) Orders (Amendment) Act,2002
The Constitution (Scheduled Caste and Scheduled Tribes) Orders (Amendment) Act,2002
The Constitution (Scheduled Caste) Order (Amendment) Act,2007
% 2. Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from
one State/Union Territory Administration.
2. This certificate is issued on the basis of the Scheduled Castes/ Scheduled tribes certificate issued
to Shri/Shrimati __________________________Father/mother _____________________________ of
Shri/Srimati/Kumari*____________________________________________________ of
village/town*_________________________________________ in District/Division* _________________of the