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Government of West Bengal
Backward Classes Welfare Department
Application form for OBC NCL Certificate
Applied For:
*
- SELECT -
Central
Do you have any digitized caste certificate:
*
- SELECT -
YES
NO
Do you have any Manual Caste Certificate:
*
YES
NO
Upload Manual Certificate
*
Only PDF allowed (Max 100KB)
Certificate No :
*
Date of Issue:
*
.
Verify
1. Application to:
State :
*
West Bengal
District
*
- SELECT FROM THE LIST -
Sub-Division
*
- SELECT FROM THE LIST -
Block/municipality
*
- SELECT FROM THE LIST -
GP/Ward
*
- SELECT FROM THE LIST -
2. Application For:
OBC
-- SELECT FROM THE LIST --
OBC-A
OBC-B
Caste/Tribe/Community:
*
-- Select Caste --
3. Name:
*
4. Father's Name:
*
5. Mobile:
6. Email:
7. Documents Required(Atleast One)
*
A. Epic No.:
B. Aadhar No.:
C.(i) Select Category:
Select Category
AAY
PHH
SPHH
RKSY-I
RKSY-II
GEN
C.(ii) Khadya sathi No.:
8.(A) Date of Birth
*
(B) Present Address
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District
*
- SELECT DISTRICT FROM THE LIST-
Alipurduar
Bankura
Birbhum
Cooch Behar
Dakshin Dinajpur
Darjeeling
Hooghly
Howrah
Jalpaiguri
Jhargram
Kalimpong
Kolkata
Maldah
Murshidabad
Nadia
North 24 Parganas
Paschim Bardhaman
Paschim Medinipur
Purba Bardhaman
Purba Medinipur
Purulia
South 24 Parganas
Uttar Dinajpur
Police Station
*
- SELECT POLICE STATION FROM THE LIST-
Gp/Ward
*
Village/Town
*
Post Office
*
Pin
*
9. Nationality :
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INDIAN
10. Religion:
*
- SELECT FROM THE LIST -
Hinduism
Jainism
Christianity
Jew
Islam
Buddism
Meiteism
Parsi
Sikhism
Zoroastrian
No religion
--Other religion--
11. Gender:
*
- SELECT FROM THE LIST -
MALE
FEMALE
TRANSGENDER
OTHERS
12. Income Certificate :
*
Choose file
13. Applicant's photograph :
*
Choose file
14.Relevant Document for Requirement of NCL :
Choose file
15. A. Parent's Service Details:
a. Service details of Father :-
1. Type of Organization :
*
- Select From The List -
Constitutional Posts
Central Government
State Government
Equivalent or comparable to Government Service
Armed Forces
Profession not equivalent or comparable to Government service/Business/Trade(please Specify)
None
2. Name of the Organization :
3. Date of Joining in Service :
4. Service Status at the time of joining :
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or Comparable
Other Group/Class or Equivalent or Comparable
5. Service Status at the age of 40 years :
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or Comparable
Other Group/Class or equivalent to comparable
Death or permanent incapacitation
6. Serivce Status at Present:
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or Comparable
Other Group/Class or Equivalent or Comparable
Retirement
Death or permanent incapacitation before retirement
Death or permanent incapacitation after retirement
Whether either of parents employed in International Organization (UN, IMF, World Bank etc.) prior to death or permanent incapacitation before retirement :
Yes
No
Period of employment in International Organisation:
7. Type of Armed Force:
- Select From The List -
Army
Navy
Air Force
Para Military Force
Rank in Service:
- Select From The List -
Colonel or Equivalent and above
Below the rank of Colonel or Equivalent
b. Service details of Mother :-
1. Type of Organization :
*
- Select From The List -
Constitutional Posts
Central Government
State Government
Equivalent or comparable to Government Service
Armed Forces
Profession not equivalent or comparable to Government service/Business/Trade(please Specify)
None
2. Name of the Organization :
3. Date of Joining in Service :
4. Service Status at the time of joining :
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or comparable
Other Group/Class or Equivalent or Comparable
5.Service Status at the age of 40 years :
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or comparable
Other Group/Class or comparable to Government Service
Death or permanent incapacitation
6.Serivce Status at Present:
- Select From The List -
Group A/Class I or Equivalent or Comparable
Group B/Class II or Equivalent or Comparable
Other Group/Class or Equivalent or Comparable
Retirement
Death or permanent incapacitation before retirement
Death or permanent incapacitation after retirement
Whether either of parents employed in International Organization (UN, IMF, World Bank etc.) prior to death or permanent incapacitation before retirement :
Yes
No
Period of employment in International Organisation:
7. Type of Armed Force:
- Select From The List -
Army
Navy
Air Force
Para Military Force
Rank in Service:
- Select From The List -
Colonel or Equivalent and above
Below the rank of Colonel or Equivalent
B. Agricultural Land Holding: owned by mother, father & minor children
i) Location:
ii) Size of Holding:
iii) Size of Irrigated land:
iv) Size of Unirrigated land:
v) Percentage of irrigated land holding to statutory ceiling limit under State Land Ceiling Laws:
vi) If land holding is both irrigated/unirrigated total irrigated land holdings on the bases of conversion formula in State Land Ceiling Law:
vii) Percentage of total irrigated land holding to statutory ceiling limit as per (vi):
C. Parents Income/Wealth :
Income/Wealth of Father :-
i) Annual income from salary:
ii) Annual income from other resources (excluding salary & agricultural land :
iii) Whether Tax Payer (if yes, a copy of the last three(3) years Return be furnished) :
Yes
No
iv) Whether covered in Wealth Tax Act (if so furnish details) :
Yes
No
Income/Wealth of Mother :-
i) Annual income from salary:
ii) Annual income from other resources (excluding salary & agricultural land :
iii) Whether Tax Payer (if yes, a copy of the last three(3) years Return be furnished) :
Yes
No
iv) Whether covered in Wealth Tax Act (if so furnish details) :
Yes
No