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Self Declaration

The document is a self-declaration by a woman stating her permanent residency in West Bengal for over 10 years and providing her residential address. She declares that her monthly family income does not exceed Rs. 1000 and that she is not supported by any relatives. The declaration affirms the truthfulness of her statements and acknowledges the consequences of providing false information.

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pchatterjee1411
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3 views1 page

Self Declaration

The document is a self-declaration by a woman stating her permanent residency in West Bengal for over 10 years and providing her residential address. She declares that her monthly family income does not exceed Rs. 1000 and that she is not supported by any relatives. The declaration affirms the truthfulness of her statements and acknowledges the consequences of providing false information.

Uploaded by

pchatterjee1411
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

SELF DECLARATION

.wife of Late....
1, Smt.
do solemnly declaring
1) That. Iam a permanent resident of West Bengal for not less than 10 years.
2) Myresidentialaddress is
Village/Ward No.
Street:
House/ Flat Name:
Post Office:
Police Station:
District
PIN:.ce
3) That, my monthly family income does not exceed Rs. 1000/- and not being maintained by anyone ofmy
relations.
4) That, all the statements madeabove are true and best of my knowledge ; if any information is found falke
at any time my application will be cancelled automatically.
5) That, lam signing this declaration knowingfully well about the content ofthe declaration.
Date: Signature of the applirtt/
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