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OF ANDHR

mee seva

AP11 4328987 5

GOVERNMENT OF ANDHRA PRADESH


REVENUE DEPARTMENT

Application No

CGCO117127860226
Date: 29/05/2017

cOMMUNITY, NATrVITY & DATE OF BIRTH CERTIFICATE


.This is to certify that the Sri/Srimathi/Kumari sHAIK MAHAMAD RIYAZ S/0 / D/o / M/o / F/o / W/o /
H/o/C/o Sri. SHAIK MAHAMMAD RAFI of PATIBANDLA village/ Town of Pedakurapadu Mandal of Guntur
Distnct of the State Andhra Pradesh belongs to Shaik-(BCE) Community / Caste which is recognized as
Backward Class under i)G.0.Ms No.1793, Education, dt.23.09.1970 as amended from time to time i)
G.O.Ms No.23, BCW(c2) Dept, dt.07.07.2007 as amended from time to time .
2.It is certified that the Sri/Srimathi/Kumari************ is a native of Locality/Landmark of
******** villagee Town of ****** ****** Mandal of ************ District of the State Andhra
Pradesh.
3.It is certified that the place of Birth Sri/Srimathi/Kumari ************ is of ************ village/
Town of ********* Mandal of ************ District of the State Andhra Pradesh.
4.It is certufied that the Date of Birth Sri/Srimathi/Kumari SHAIK MAHAMAD RIYAZ is 27 Day Auqust
Month 2000 Year (in words) Two Seven - August - Two Zero Zero Zero as per the declaration given by
his/her Father/Mother/Guardian and as entered in the School records where he/she studied.

Certified By

Name: S.v. Srinivasulu


Designation: TAHSILDAR
Mandal: Pedakurapadu

Note This is Drgitally Signed Certificate, does not require physical signature. And this certificate can be verifed at
htp://www.ap.meeseva.gov.in/ by furrnishing the application number mentioned in the Certificate.

http./apasp.meeseva.gov.in/APSDCPortal/Userlinterface/citizen/RevenueServices/Integrat... 6/17/2017
Note; This is a Digitally Signed Certificate and does not require physical signature. This certificate can be veritied
at http//www.ap.meeseva.gov.in/byfurnishing the application number mentioned in the certficate

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