SELF DECLARATION
I, Mr./Mrs./Ms. ________________________________, S/o / D/o / W/o
________________________________, Age: ______ years, Resident of Village
____________________, Post Office ____________________, District ____________________,
State ____________________, do hereby declare that the information furnished in this application
form and the self■declaration enclosed is true to the best of my knowledge and belief. If any
information furnished by me is found to be incorrect or if any fact has been suppressed, I shall be
solely responsible for the same. In case of selection of my candidature, I shall produce all original
documents for verification and any discrepancy found later may lead to cancellation of my
candidature. I shall be responsible for any legal action taken against me for wrong declaration.
Place: __________________________
Date: ___________________________
Signature of the Applicant
__________________________
Name: ______________________