Signature of the Revenue Officer 03/06/2026 FORM No. I (See Rule 3) GOVERNMENT OF ODISHA Office of the Tahasildar GOPALPUR Miscellaneous Certificate Case No E-SCO/2021/116351 SCHEDULED CASTE CERTIFICATE This is to certify that Shri A SAGAR son of Smt A BIJAYALAXMI and Shri A LAXMINARAYANA , of village/town GOPALPUR P.S GOPALPUR in the district GANJAM in the state of Odisha belongs to BHANDARI caste which is recognized as Scheduled Caste 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. Shri A SAGAR and his family ordinarily reside(s) in village/town GOPALPUR of GOPALPUR district in the state of Odisha. **** 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 visit https://edistrict.odisha.gov.in (iv) Tampering of this Certificate will attract penal action. Reference No: E-SCO/2024/837107 To View: https://edistrict.odisha.gov.in/