FORM No. III (See sub-rule (1) of rule 4)   No…………                    Office of the………………………….…………                         Dated…………………………………..………..   COMMUNITY CERTIFICATE [ Issued under rule 4 of the Kerala (Scheduled Castes and Scheduled Tribes) Regulation of Issue of Community Certificate Rules, 2002]       Certified that Sri./Smt./Kumari……………………………………………………………..…   ……………………………………………………………………………………wife/son/daughter of   Sri./Smt………………………………………………….…..…..of……………….……………village   …………………….………..Taluk……………………………….in…………………….…….district   Of the State of Kerala belongs to the………………………………….…….Caste/Tribe which is   recognised Scheduled Caste/Scheduled Tribe under   The Constitution (Scheduled Castes) Order, 1950 The Constitution (Scheduled Tribes) Order, 1950   This Certificate is issued for…………………………………………………………   ………………………………………..purpose   Signature Name and designation of the Competent Authority (Seal)