Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697804204952.pdf (India)
REVENUE DEPARTMENT, GOVT.

OF NCT OF DELHI APPLICATION FORM –OBCCERTIFICATE 1. e-District Registration Number : (For already Registered User- Not to be filled in by first time Applicants or those having Aadhaar number) OR BENEFICIARY DETAILS : 2.

UID (AADHAAR) No 3.

Name of Beneficiary 4.

Name of Father 5.

Name of Mother 6.

Name of Spouse 7.

Gender 8.

Date of Birth(DD/MM/YYYY): DD MM YYYY : : : : : Male Female Other Beneficiary color Passport Size Photograph Size – 5 x 4.5 (Cm.)
Or 2 x 1.75 (Inch) 9.

Mobile No.

: e-Mail ID : @ (in case of minor, provide parents contact details) 10.

Present Address (Address of Parents in case of Minor ) House Name/No : : Locality Sub- division : State : PIN Code : Sub-Locality : Village/Town : District Country 11.

Whether the Present and Permanent Address is same : 12.
If No, Permanent Address (Address of Parents in case of Minor) Yes House Name/No : : Locality Sub- division : : State : PIN Code Sub-Locality Village/Town District Country No : : : : : 13.

Please select ANY one of the following four Categories that you fall in: DETAILS REQUIRED FOR ISSUANCE OF OBC CERTIFICATE a.

Family residing in Delhi since prior to 1993 AND OBC certificate issued to brother/sister/father or blood relative from paternal side.

(Applicant will get Delhi OBC certificate) i.


Please Attach Copy of Caste Certificate ii.

Name of Caste: iii.

Issued to: iv.

S.No.

of the certificate: v. Date of Issuance: vi.

Relationship of the Applicant with certificate Holder: vii.
Proof of relationship: (Please attach a self-attested copy of the same ) Aadhaar card Voter ID Card Driving License Passport Ration Card PAN Card Birth Certificate Any Government ID containing names of both the beneficiary and certificate holder as family member Document No.

: 1 b.

Family Migrated to Delhi after 1993 and OBC Certificate issued to Father/ Paternal Relative of the applicant from State of origin( Applicant will get other state OBC certificate) i.

Attach copy of caste Certificate ii.


Name of Caste: iii.

S.No.

of the certificate: iv.

Date of Issuance: v. Relationship of Appliant with certificate holder: vi.

Proof of Relationship (Please attach a self-attested copy of the same ) Aadhaar card Voter ID Card Passport Ration Card Driving License PAN Card Birth Certificate Any Government ID containing names of both the beneficiary and certificate holder as family member vii.

Name of State of Origin: viii.

Name of District of Origin: Document No.


: c. Family Residing in Delhi since prior to 1993 and no OBC certificate issued to any paternal relative.

(Eligible for Delhi OBC) i.

Name of Caste: ii.

Proof of Residence in Delhi prior to 1993: iii.

Field Verification shall be mandatory in such cases d. Where OBC certificate already issued to applicant from Delhi or any other state(Eligible for Central OBC certificate) i.

Attach Copy of OBC certificate of Applicant ii.

S.No.

of the certificate: iii.


Issuing Authority: iv.

Date of Issuance : v. Name of State of Issuance: 14.

Identity Proof of Beneficiary(Please tick one, provide the document No.

and attach the same ) Aadhaar Card Voter ID Card PAN Card Any Govt.

recognized document Passport Ration Cardwith Photograph Driving License Letter (attested) from SchoolPrincipal (for minor only) School ID Card (for minor only) Birth Certificate (for minor below 5 years only) Document No 15.
IdentityProofof Parents ( incase parentsappliedonbehalfofminor)(Pleasetick one,provide thedocument No.andattachthe same) Aadhaar Card Voter ID Card Any Govt.

recognized document PAN Card Passport RationCard with Photograph Driving License Document No : 16.

Present Address Proof of Beneficiary/Parents(in case of minor) (Please tick one, provide the document No.
and attach the same ) AADHAR Card Passport Water Bill Utility Name Telephone Bill Company name Rent Agreement (Registered) Voter ID Card Ration Card Driving License Electricity Bill DISCOM Name Gas Bill Any Govt.

recognized document Comp Name BankPassbook Document No : 2 17.

Permanent Address Proof of Beneficiary/Parents(in case of minor) (Please tick one, provide the document No.
and attach the same ) AADHAR Card Passport Water Bill Utility Name Telephone Bill Company name Rent Agreement (Registered) Voter ID Card Ration Card Driving License ElectricityBill DISCOM Name Gas Bill Comp Name Any Govt.

recognized document BankPassbook Document No : Date: DD MM 20YY Place: Signature of Beneficiary : (Parents Signature in case of minor) 3 18.
Annexure I CREAMY LAYER EXCLUSION CRITERIA PART-1 CONSTITUTIONAL POSTS Is the applicant a son/daughter of (a)President of India (b)Vice President of India; (c) Judges of the Supreme court and High Courts; (d) Chairman & Members of UPSC and of the State Public Service Commission; Chief Election Commissioner; Comptroller & Auditor General of India; (e) Persons holding Constitutional positions of like nature.
Yes Yes Yes Yes No No No No Yes No IMPORTANT CHECK If the answer to any of the query above is ‘YES’, then the applicants fall under “Creamy Layer Exclusion Criteria” as laid down by Govt.

of India, and the APPLICANT is, therefore, Not entitledto OBC Certificate.
Part-II-SERVICE CATEGORY Part-II(A) Is the applicant a son/daughter of (a)parents, both of whom are Class I Officers: (b) parents, either of whom is a Class I Officer; (c) Parents,bothofwhomareClass IOfficers,butoneofthem diesof suffers permanent incapacitation.
(d) Parents, either of whom is a Class I Officer and such parent dies of suffers permanent incapacitation and before such death or such incapacitation had had the benefit of employment in any International Organization like UN, IMF, World Bank, etc.for a period of not less than 5 years.
(e) Parents, either of whom are class I officers die or suffer permanent incapacitation and before such death or such incapacitation of the both, either of them has had the benefit of employment in any International Organization like UN, IMF, World Bank, etc.

for a period of not less than 5 years.


Provides that the rule of exclusion shall not apply inthe following cases: (a)Sons and daughters of parents either of whom or both of whom are Class-I Officers and such parents(s) dies/die or suffer permanent incapacitation.

(b)A lady belonging to OBC category has got married to a Class-I Officer, and may herself like to apply for a job.
Yes Yes Yes No No No Yes No Yes No IMPORTANT CHECK If the answer to any of the query above is ‘YES’, then the applicants fall under “Creamy Layer Exclusion Criteria” as laid down by Govt.of India, andthe APPLICANT is, therefore, Not entitledto OBC Certificate.

4 PART-II(B) Is the applicant a son/daughter of (a) Parents both of whom are directly recruited Class II/ Group B Officers.

(b) Parents of whom, only the husband is a Class-II Officer and he gets into Class I at the age of 40 or earlier.
(c)Parents ,both of whom are Class II Officers and one of them dies or suffers permanent incapacitation and either one of them has had the benefit of employment in any International Organization like UN, IMF, World Bank, etc.
for a period of not less than5 yearsbefore such deathor permanent incapacitation; (d) Parents of whom the husband is a Class I Officer(direct recruit or pre- forty promoted)and the wife is a Class II Officer and the wife dies; or suffers permanent incapacitation;and (e)Parents, of whom the wife is a Class I Officer(Direct Recruit or pre-forty promoted)andthehusband is a ClassII Officer andthe husband diesor suffers permanent incapacitation Provides that the rule of exclusion shall not apply in the following cases: Sons and daughter of (a) ParentsbothofwhomareClass IIOfficersandoneofthemdiesor suffer permanent incapacitation.
(b) Parents both of whom are Class II Officers and both of them die or suffer permanent incapacitation, even though either of them has had the benefit of employment in any International Organization like UN, IMF, World Bank, etc.

for a period of not less than 5 years before their death or permanent incapacitation.
Yes Yes No No Yes No Yes No Yes No IMPORTANT CHECK If the answer to any of the query above is ‘YES’, then the applicants fall under “Creamy Layer Exclusion Criteria” as laid down by Govt.of India, andthe APPLICANT is, therefore, Not entitledto OBC Certificate.

PART-II(C) Employees in Public Sector Undertakings etc Thecriteria enumeratedinA & B above inthis category will applymutatis mutandi to officers holding equivalent or comparable posts in PSUs, Banks, Insurance Organization, Universities, etc.
and also to equivalent or comparable posts and positions under private employment, Pending the evaluation of the posts on equivalent or comparable basis in these institutions the criteria specified in Category VI below will apply to the officers in these Institutions.
5 Yes No PART-III-ARMED FORCES INCLUDING PARAMILITARY FORCES Is the applicant a son/daughter of (a)Parents either or both of whom is or are in the rank of Colonel and above in theArmyandtoequivalent posts intheNavyand theAir Force and the Para Military Forces; Provided that:- I.

If the wife of an Armed Forces Officer is herself in the Armed Forces(i.e;the category under consideration)the rule of exclusion will apply only when she herself has reaches the rank of Colonel; II.
The service ranks below Colonel of husband and wife shall not be clubbed together; III.
If the wife of an officer in the Armed Forces is in civil employment, this will not be taken into account for applying the rule of exclusion unless she falls in the service category under Part NO.II in which case the criteria and conditions enumerated there in will apply to her independently IMPORTANT CHECK If the answer to any of the query above is ‘YES’, then the applicants fall under “Creamy Layer Exclusion Criteria” as laid down by Govt.of India, andthe APPLICANT is, therefore, Not entitledto OBC Certificate.
PART-IV-PROFESSIONAL CLASS AND THOSE ENGAGED IN TRADE AND INDUSTRY (I)Persons engaged in profession as a doctor, lawyer, chartered accountant, Income-Tax consultant, financial or management consultant, dental surgeon, engineer, architect, computer, specialist, film artists and other film professional, author,playwright, sports, person, sportsprofessional, media professional or anyother vocations of like status.

(II) Persons engaged intrade, business and industry.
Criteria specified against category VI will Criteria specified against category VI will apply:- apply:- Explanation: (I)Where the husband is in some profession and the wife is in a Class II or lower grade employment, the income/wealth test will apply only on the basis of the husband’s income.
(II)If the wife is in any profession and the husband is in employment in a Class II or lower rank post, then the income/wealth criterion will apply only on the basis of the wife’sincomeandthehusband’s income will not be clubbed with it.
PART-V PROPERTY OWNERS 6 A Agricultural holdings Is the applicant a son/daughter of Persons belonging to a family(father, mother and minor children)which owns (a) Only irrigated land which is equal to or more than 85% of the statutory area Or (b) Both irrigated and un- irrigated land, as follows: (1) The rule of exclusion will apply where the pre-condition exists that the irrigated area(having been to a single type under a common denominator)40% or more of the statutory calculated by excluding the un- irrigated portion).If this pre-condition of not less than 40% exists, then only the area of un –irrigated land will be taken into account.
This will be done by converting the un- irrigated land on the basis of the conversion formula existing.

Into the irrigated type-The irrigated area so computed from un- irrigated land shall be added to the actual area of irrigated land and if after such clubbing together the total areain terms of irrigated land is 80% or more of the statutory ceiling limit for irrigated land, then the rule of exclusion will apply and disentitlement will occur.
(2) The rule of exclusion will not apply if the land holding of a family is exclusively un- irrigated.

B.

Plantations (1) Coffee, tea, rubber, etc.

(2) Mango, citrus, apple plantations etc.

C. Vacant land and/or buildings in urban areas or urban agglomerations Yes No Yes No Criteria of income/wealth specified in category VI below will apply Deemed as agricultural holding and hence criteria at A above under this Category will apply.

Criteria specified in Category VI below will apply.
Explanation: Building maybe usedfor residential, industrial or commercial purpose and the like two or more such purposes.

PART-VI INCOME/WEALTH TEST Is the applicant a son/daughter of (a) Persons having gross annual income of Rs.

8 lakh or above or possessing wealth above the exemption limit as prescribed in the wealth Tax Act for a period of three consecutive years.
(b) Persons in Categories, I, II, III and VA who are not disentitled to the benefit of reservation but have incomefrom other sources of wealth which will bring them within the income/wealth criteria mentioned in (a) above.

Explanation: (1) Income from salaries or agricultural land shall not be clubbed; Yes No Y Yes No 7 (2)The income criteria in terms of rupee will be modified taking into account the change in its value every three years.

If the situation, however, so demands, The interregnum may be less.
Explanation: Wherever the expression permanent Incapacitation” occur in this schedule.

It shall mean Incapacitation which results is putting an officer out of service.

8 I aged Verify as Under: R/o 19.

Self-Declaration S/o/D/o Sh.

I. II.

III.

That the above contents are correct to the best of my knowledge and belief and nothing has been concealed therein.
That I have gone through the criterion for exclusion of Creamy layer given in Annexure I attached to this application and state that I do not fall in Creamy layer.

I further affirm that- I am awarethat in casetheinformationfurnishedaboveisfoundtobeincorrect,Ishallbeliablefor prosecution under section 177 & 191 of the Indian Penal Code, which stipulates as under:- 177.
Furnishing False Information- whoever, being legally bound to furnish information on any subject to any public servant, as such, furnishes, as true, information on the subject which he knows or has a reason to believe to be false, shall be punished with simple imprisonment for a term which may extend to six months, or fine which may extend to one thousand rupees, or with both; Or, if the information which he is legally bound togive respects the commission of an offence, or is requiredfor the purpose of preventing the commission of an offence, or in order to the apprehension of an offender, with imprisonment of either description for a term which may extend to two years, or with fine, or with both.
191.

Giving false evidence- Whoever being legally bound by an oath or by an express provision of law to state the truth, or being bound by law to make a declaration upon any subject, makes any statement which is false, and which he either knows or believes to be false or does not believe to be true, is said to give false evidence.

IV.

Providing any false evidance shall be punishable under section 193 of IPC, 1860 which provides imprisonment for a term upto three years and fine.
Date: DD MM 20YY Place: Signature of Beneficiary : (Parents Signature in case of minor) 9