To Whom It May Concern

Office No. ___________

Dated: ____________

Certified that the name of Sh. / Smt./Ms. ______________________ S/o., W/o., D/o.
Sh. ____________________ R/o. Village / Town ___________________________
District ______________ is appear in the BPL list of Village / Town ___________ for
the year _____________ at Sr. No. _________. The said BPL list is the latest as per
our official record. The person named above is holden of BPL Ration Card No.
___________ and said BPL Ration Card has not been cancelled.

Date:
Place:

Signature of Concerned
Additional Deputy Commissioner
cum-Chief Executive Officer
DRDA or his authorised officer / official