Application Form For Economically Weaker Section (EWS) Income Certificate
Applicant Details:
Present Address:
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Postal Address is same as Permanent Address:
Income Details*:
Gross Annual Income includes Salary, Agriculture, Business, Profession etc., for the financial year prior to the year of application (Applicant/His/Her Family*): _________________ (In Rupees)
Assets Information (Applicant/ His/Her/Family*):
i) 5 Acres of agricultural Land and above : Yes/No
ii) Residential flat of 1000 sq. ft. and above: Yes/No
iii) Residential plot of 100 sq. yards and above in notified municipalities: Yes/No
iv) Residential plot of 200 sq. yards and above in areas other than the notified municipalities: Yes/No
* Represents all the fields are mandatory.
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Application Form
For
Economically Weaker Section Income Certificate
For the Financial year ________
Applicant Details:
| Applicant Name*: | Father Name*: |
| Gender*: | Date of Birth: |
| Aadhaar Number (optional): |
| Caste Category*: | Sub Caste Category*: |
Present Address:
| Door No*: | Locality/Landmark: |
| State*: |
| District*: | Mandal*: | Village*: | Pincode*: |
Postal Address is same as Permanent Address:
| Door No*: | Locality/Landmark: |
| State*: |
| District*: | Mandal*: | Village*: | Pincode*: |
| Mobile Number*: | Mail Id: |
| Ration Card Number: |
Income Details*:
Gross Annual Income includes Salary, Agriculture, Business, Profession etc., for the financial year prior to the year of application (Applicant/His/Her Family*): _________________ (In Rupees)
Assets Information (Applicant/ His/Her/Family*):
i) 5 Acres of agricultural Land and above : Yes/No
ii) Residential flat of 1000 sq. ft. and above: Yes/No
iii) Residential plot of 100 sq. yards and above in notified municipalities: Yes/No
iv) Residential plot of 200 sq. yards and above in areas other than the notified municipalities: Yes/No
Note: The term “Family“ for this purpose will include the person who seeks benefit of Reservation , His/Her parents and siblings below the age of 18 years as also His/Her spouse and children below the age of 18 years.
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Documents to be uploaded:
i) Application Form*
ii) Ration Card/Epic Card/Aadhaar Card*
iii) Copy of IT Returns/Pay Slips (Any of other Documents)
iv) Affidavit
Note:
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Documents to be uploaded:
i) Application Form*
ii) Ration Card/Epic Card/Aadhaar Card*
iii) Copy of IT Returns/Pay Slips (Any of other Documents)
iv) Affidavit
Note:
- ͏ I hereby declare that the above mentioned information is furnished on best of my knowledge. If information & declaration is found false, I am liable for prosecution.
- I don’t belong to SC, ST and BC/OBC Caste.
* Represents all the fields are mandatory.
| Date: | Signature of the Applicant |
Disclaimer: This application form has been issued by Andhra Pradesh Govt other state govt authorities may use their own format. This form may be useful to understand the requirement of terms to get the EWS Certificate.