Economically Weaker Section (EWS) – Application Form for Income Certificate

Economically Weaker Section (EWS) – Application Form for Income Certificate

* Affix Your

Passport

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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. 

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.
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  • 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.

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