FL Pere een yerscncree

**. TO BE FILLED UP BY THE INSTITUTION

‘This is to certify that JbVMst__ Alf ara ful alam molia Son/daughter

of Tb/Mst. Golam Corre nto Lia is a student of Kau ( p-) Class /

Course/Year 2.072) 23 during the session.

otal,

Princlapliaase sie Men

of the trstitution.

13. TO BE FILLED UP BY THE INCOME CERTIFICATE ISSUING AUTHORITY

’ : ¢( ue

This is to Certify that Jb/Mst WShwa fut Alam Malla Father /Mother/

Guardian of JwMst_Ci lam bve'rt 04/4 isa permanent resident VWI = U taytutho

ofichate, Pe Golabare, FS: anne’ ZB) 2G PLIQAWS

His /Her annual income does not exceed Rs, G90 0G) (Rupees SOK f ho kKlonol

Pat a ae ieee sole)

only.

—] Re

Fe A ee ek gl

M.P/MLA/Employer/Principal/Head Master of the Institution/ B.D.O/Gazetted Officer)

14,** FOR IMAM/ MOAZZEN ONLY

1, do hereby declare that I am working as an Imam / Moazzen of

mosque situated at Vill / Premises

P.O. PS, Dist.

The applicant is my Son/daughter.

Counter Signature of the Secretary, Signature of. Imam/Moazzen

Mosque Committee with seal E.C. No

N.B**

1. The column no. 14 must be filled up, If the father of the applicant is working

as an Imam/ Moazzen. (Document related to Imam/ Moazzen is required).

2. Incomplete application will be rejected.

3. The last date of submission of the application on 30.11.20

Contact this candidate