Government of Kerala: Income Certificate

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FORM 10C

(See Rule 3)

GOVERNMENT OF KERALA
KUMMIL VILLAGE OFFICE

INCOME CERTIFICATE

No. 73743533 Date: 12/12/2022

Certified that the Annual Family Income of the person with the details mentioned below from all source is

36000 (Rupees thirty six thousand only)

Name of Person to whom certificate is


SARASWATHIAMMA
issued
Gender Female
Age 84

Name of Guardian BHASKARAPILLAI

Address AYILYAM, 02/193, ANAPPARA

Post Office with Pin code KADAKKAL, 691536

Name of Localbody Kummil


Village Kummil
Taluk Kottarakkara
District Kollam
Date of Issue of Certificate 12/12/2022
Designation of the Issuing officer VILLAGE OFFICER
Remarks Nil

This certificate is issued on the basis of details given in the application and further verifications. Details,if any, given in the application
and other documents attatched along with documents are found to be incorrect at a later date, the competent authority has all the right to
cancel the certificate without prior intimation.

This Certificate is valid for a period of one year from the date of issue.

Security Code : RT6YD

NOTE:

1. This digitally signed document is legally valid as per the Information Technology (IT) Act, 2000.
2. Authenticity of this document can be verified from http://edistrict.kerala.gov.in/ and submitting the Certificate Number and Security
code. Alternatively, please contact : 155300, 0471155300, 04712335523

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