OFFICE OF THE COMMISSIONER OF
TRIBAL WELFARE / SOCIAL WELFARE /
BACKWARD CLASS WELFARE
Govt. of Andhra Pradesh
MEMO
R.C. No
Date:
Sub:
Admission into Professional Courses - Under SC/ST/ BC Quota - Provisional
Clearance on SC / ST / BC status claim issued - Regarding
Ref.:
Sri / Kum
S/o. D/o., Sri
Native of
Village
Mandal
District
belonging
to
Caste/ Tribe, MR No.
may be
granted provisional Admission under SC/ST/BC Category in
course
for the year
For Commissioner of Tribal Welfare /
Social Welfare / Backward Class Welfare
PENDING CLEARED
UNDERTAKING
I hereby solemnly affirm and sincerely state that I belong to SC / ST / BC - A/B/C/D/E community
viz.
and that my community declared before you and documents filed by me before
the admission authority and you in support of my community is true and correct and the community
certificate produced by me to the above effect is genuine. I hereby agree for detailed enquiry into status
claim by the Commissioner of TW/SW/BCW, Telangana, Hyderabad or any other investigating agency
and abide by the findings of the said enquiry. Further I agree for termination of my provisional admission
in the said course on the basis of the findings of the said enquiry. I hereby undertake that I shall not seek
any legal remedy against my SC/ST/BC-A/B/C/D/E claim being found to be false or wrong and I understand
that I shall be liable for criminal prosecution in the event of my SC/ST/BC-A/B/C/D/Eclaim being
found to be false or wrong
Signature of Parent / Guardian
Relationship with Candidate
Signature of Candidate
Namo in Block Letters how to fill up the form
Answers
Answer:
OFFICE OF THE COMMISSIONER OF
TRIBAL WELFARE / SOCIAL WELFARE /
BACKWARD CLASS WELFARE
Govt. of Andhra Pradesh
MEMO
R.C. No
Date:
Sub:
Admission into Professional Courses - Under SC/ST/ BC Quota - Provisional
Clearance on SC / ST / BC status claim issued - Regarding
Ref.:
Sri / Kum
S/o. D/o., Sri
Native of
Village
Mandal
District
belonging
to
Caste/ Tribe, MR No.
may be
granted provisional Admission under SC/ST/BC Category in
course
for the year
For Commissioner of Tribal Welfare /
Social Welfare / Backward Class Welfare
PENDING CLEARED
UNDERTAKING
I hereby solemnly affirm and sincerely state that I belong to SC / ST / BC - A/B/C/D/E community
viz.
and that my community declared before you and documents filed by me before
the admission authority and you in support of my community is true and correct and the community
certificate produced by me to the above effect is genuine. I hereby agree for detailed enquiry into status
claim by the Commissioner of TW/SW/BCW, Telangana, Hyderabad or any other investigating agency
and abide by the findings of the said enquiry. Further I agree for termination of my provisional admission
in the said course on the basis of the findings of the said enquiry. I hereby undertake that I shall not seek
any legal remedy against my SC/ST/BC-A/B/C/D/E claim being found to be false or wrong and I understand
that I shall be liable for criminal prosecution in the event of my SC/ST/BC-A/B/C/D/Eclaim being
found to be false or wrong
Signature of Parent / Guardian
Relationship with Candidate
Signature of Candidate
Namo in Block Letters how to fill up the form