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Annexure-T Government of Himachal Pradesh (Name & Address of the authority issuing the certificate) INCOME & ASSET CERTIFICATE TO BE PRODUCED BY ECONOMICALLY WEAKER SECTIONS > Certificate No.......... Dated:...... VALID FOR THE YEAR.......... i This is to certify that Shri/Smt./Kumari 00 a son/daughter / wile ee )Spermanent. resident of Village/town __. Post Office _..__ District in the State of Himachal Pradesh, Pin Code whose photograph is attested below belongs to Economically Weaker Sections, since the gross annual income* of his/her family** is below Rs. 4 Lakh (Rupees Four Lakh only) for the financial year _____.. His/her family does not own or possess any of the following assets***:- i. More than 1 hectare of Agricultural Land in rural areas and 500 M2 land in urban areas; ii. Residential flat/house of more than 2500 square feet in rural/urban areas. iii. Family of income tax payee; iv. Family of Regular/Contract employees of the Central Government, State Government, Board, Corporations and autonomous bodies and Public Sector Undertakings etc.; z Shri/Smt./Kumari belongs to the ag caste which is not recognized as a Scheduled Caste, Scheduled Tribe and Other Backward Classes. Signature with seal of Office ate Nerre Designation Se Recent Passport size attested photograph of the applicant *Note 1: Income covered all sources i.c. salary, agriculture, business, profession etc, a **Note 2: 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. "Note 3: The property held by a ‘Family* in different locations or different places/Zities have been clubbed while applying the land or property holding test to determine EWS status. i « eek 
