• This Application Is Addressed To Deputy Collector And Sub-Divisional Office
  • The Fields marked with * are compulsory.
  • Incase relevant documents are not uploaded,the application will be subjected to cancellation.
  • The Reference No. generated after submitting the application online should be maintained for tracking the status of the application.
  • Click Here to download Affidavit Format
  • Online Application for obtaining Certificate of Caste

    Applicant's Name*: Mobile No:
    Email Id: Id Proof:
    Enter the id Proof Number*:
    Personal Details
    Title*: Gender*:
    Applicant Name*:
    **Name should be as per Birth Certificate
    The Applicant is of
    Survey No: Sub-Div No:
    Taluka*: Village*:
    Caste Type*: Creamy Layer*:
    Caste*: Caste Details:
    Date of Birth: Place of Birth:
    Applicant's Age*: (in years)
    Earlier Applied:
    Purpose of Certificate *:
    Income Details
    Source of Income*:
    Applicant's Income*:
    Family Income*:
    Affidavit Details
    Registration No: Registration Date:
    Executed Before: Sworn By:
    Samaj Certificate
    Issued By*: Issued Date*: Pick a date (DD-MMM-YYYY)
    Previous Caste Certificate Issue Details
    Issued To: Relation with Applicant:
    Certificate No: Certificate Date: Pick a date (DD-MMM-YYYY)
    Issued By:
    Non-Resident Goan:
    Enter The Letters Shown In The Textbox Below

  • Note:1. If it is found that the applicant questions set above are incorrect by benefit derived hereby be summarily cancelled.
  • 2. Application will be required to produce proof with regard date and place of Birth or any other documents showing the applicants or the parents are on Goa prior to 19/2/1968 and Caste and such proof as may.
  • 3. Following documents should be uploaded (1)Certificate from Samaj. (2)Parents Caste certficate issued by the prescribed Authority.(3)An affidavit in the prescribed form given above.(4)Original Income Certificate issued by the competant Authority (5)Vikas Patrika from presribed authority(only in case of non-OBC)