SC/ST Certificate Format for candidates applying for appointment to posts under Government of India -Download Form-IV
FORM-IV
FORMAT FOR SC/ST CERTIFICATE
A candidate who claims to belong to one of the Scheduled Cast or the Scheduled Tribe should submit in support of his claim an attested/clarified 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. Wherever photograph is an integral part of the certificate, only attest photocopies of such certificates and not any other attested or true copy will be accepted.
(The format of the certificate to be produced by Scheduled Castes and Scheduled Tribes candidates applying for appointment to posts under Government of India)
1. This is to certify that Shri/Smt/Km __________________________ Son/Daughter of Shri ______________________________________ of village/town/* in District/Division*_______________________ of the state/union territory * _______________________ belongs to the Caste/tribes* under ________________ which is recognized as a Scheduled Caste/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) 1956, The Bombay Reorganisation Act 1960 & the Punjab Reorganisation Act 1966, the state of Himachal Pradesh Act 1970, the North-Eastern Area (Reorganisation) Act 1971 and the Scheduled Castes and Scheduled Tribes Order (Amendment) Act 1976. Mizoram State Act, 1986 Arunachal Pradesh State Act, 1986, Goa and Daman & Diu/Modification Act, 1987 by modified.
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 (Pondicherry) Scheduled Castes Order 1964 @
The Constitution (Scheduled Tribes)(Uttar Pradesh) Order 1964 @
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 Caste Order 1978@
The Constitution (Sikkim) Scheduled Tribes Order 1978@
The Constitution (Jammu & Kashmir) Scheduled Tribes Order 1989@
The Constitution (SC) Orders (Amendment)1990@
The Constitution (ST) Orders (Amendment) Ordinance 1991@
The Constitution (ST) Orders (Second Amendment) Ordinance 1991@
Scheduled Caste and Scheduled Tribe Order (Amendment) Act 2002 @
The Constitution (Scheduled Caste) order (Amendment) Act 2002
The Constitution (Scheduled Caste and Scheduled Tribe order (Amendment) Act 2002
The Constitution (ST) Orders (Amendment) Ordinance 1996@ &2.Applicable in the case of Scheduled Castes, Scheduled Tribes persons who have migrated from one State/Union Territory Administration.
This certificate is issued on the basis of the Scheduled Castes/Scheduled tribes certificate issued to Shri/Smt/Km_____ Father/mother _______________ of Shri/Smt/Km*__________________ of Village/Town* ______________ in District/Division* __________________ of the state/Union Territory _______ who belong to the __________ Caste/Tribe which is recognized as a Scheduled Caste/Scheduled Tribe in the State/Union Territory* issued by the _____________ dated____________ & 3. Shri/Smt/Km and/or* his/her family ordinarily reside(s) in Village/Town* _______ of ________________ District/Division* ________________ of the State/Union Territory of ___________________________.
Signature _________
Place__________ Designation___________
Date___________ (with seal of office)
State/Union Territory
Please delete the words which are not applicable.
@ Please quote specific presidential order.
& Delete the paragraph which is not applicable.
Note:-The term ordinarily reside(s) used here will have the same meaning as in section 20 of the representation of the People Act 1950.
List of authorities empowered to issue Caste/Tribe Certificate;
(i) District Magistrate/Additional District Magistrate/Collector/Deputy Commissioner/Additional Deputy Commissioner/Dy Collector/1st Class Stipendiary Magistrate/Executive Magistrate.
(ii) Chief Presidency Magistrate/Additional Chief Presidency Magistrate/Presidency Magistrate.
(iii) Revenue Officer not below the rank of Tehsildar.
(iv) Sub-Divisional Officer of the area where the candidate and/or his family normally resides.
(v) Administrator/Secretary for Administrative/Department ______ (Lakshwadeep).
Note:-ST candidates belonging to Tamil Nadu State should submit caste certificate ONLY FROM THE REVENUE DIVSIONAL OFFICER.
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Form-III for Ex-Serviceman
Form-V for OBC
Form-VI for OBC declaration
Form-VII for Games/Sports (National/International)
Form-VIII for Games/Sports (Inter University Competition)
Form-IX for Games/Sports (State School Team in the National Games
Form-X for Social Welfare
Form-XI for Govt. Servants claiming age concession
Form-XII – Income Aassest EWS – Certificate to be Produced by Economically Weaker Sections
Undertaking
Source: https://www.mesgovonline.com/mesdmsk/formIV.pdf
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