4. I hereby declare that, in pursuance of obtaining the Social Status Certificate, the information rendered by me in the Application presented in the prescribed form before the Competent Authority, is true to the best of my knowledge and belief and if such information is found false or incorrect, then proceedings in accordance with Section 8-13 of Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013 shall be initiated ag

Signature................
Name of the Applicant..................
Verification
Verification
Signature..............
Name of the Applicant...............
Form-2B
Form-2B
[ See Rule 15(1)]
Affidavit by Person appointed, admitted, elected, named or nominated on the Reserved Seat
Affidavit by Person appointed, admitted, elected, named or nominated on the Reserved Seat
(1) I have submitted an Application for the post/seat/benefit/service reserved for Scheduled Castes/Scheduled Tribes/Other Backward Classes.
(2) My appointment/admission/election/naming/nomination have been made under the reserved post/seat.
(3) I have submitted my Social Status Certificate issued by Competent Authority..............(name and post of authorized officer) certifying that I belong to Scheduled Castes/Scheduled Tribes/Other Backward Classes.
(4) The Social Status Certificate submitted by me has been issued by the prescribed officer and through prescribed process and in order to get such certificate, all information rendered by me to the Competent Authority is true to the best of my knowledge and belief.
(5) In case a complaint is received in connection with above mentioned Certificate that Certificate has been obtained fraudulently or wrongly and if on this basis or otherwise, suo moto, an inquiry is held by the District Level Certificates Verification Committee regarding my Social Status or the Social Status Certificate is referred for inquiry to the High Power Certification Scrutiny Committee and if the above committee or committees after inquiry and decision pass an order stating that Certificate has been obtained wrongly or fraudulently, my appointment/admission/election selection, profit given, facilities given, as the case may be, can be cancelled/terminated/ excluded with immediate effect by the non-applicant (name of concerned public employer/educational institution/statutory body/State Government/Central Government)................., and I shall be liable to refund the amount spent on such appointment/admission/ election/selection/profit/facilities given etc. and the above-mentioned amount may be recovered as arrears of land revenue, and I shall also be liable to action prescribed in Sections 8-13 of Chhattisgarh Scheduled Castes, Scheduled Tribes and Other Backward Classes (Regulation of Social Status Certification) Act, 2013.
Signature................
Name of the Applicant.................
Verification
Verification
Signature................
Name of the Applicant.................
Form-2C
Form-2C
[ See Rule 16 (3 & 4)]
Affidavit to be filed before District Level Certificates Verification Committee
Affidavit to be filed before District Level Certificates Verification Committee
I, ................ son/daughter/wife
............of..........., aged.....Year occupation , resident of.....
Village........, Tehsil..........., District...........
............. State
hereby solemnly affirm that:
Affix passport size photograph