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Self-Declaration Form for Odisha

The document contains two self-declaration forms for individuals to authenticate certificates in Odisha, India. The first form is for individuals to declare marriage, birth, health, or other certificates as genuine. It states that providing false information could result in criminal penalties. The second form is similar but is a self-certification for authenticating marriage, birth, or health certificates specifically. Both forms require signatures before an officer of the Odisha Home Department.

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100% found this document useful (1 vote)
2K views3 pages

Self-Declaration Form for Odisha

The document contains two self-declaration forms for individuals to authenticate certificates in Odisha, India. The first form is for individuals to declare marriage, birth, health, or other certificates as genuine. It states that providing false information could result in criminal penalties. The second form is similar but is a self-certification for authenticating marriage, birth, or health certificates specifically. Both forms require signatures before an officer of the Odisha Home Department.

Uploaded by

S sahu
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 for Authentication of Certificate
  • Self-Certification for Authentication of Documents

Annexure-I

SELF-DECLARATION FOR AUTHENTICATION OF


CERTIFICATE

I, ,Son/daughter of Shri/ Smt/ Mrs


age______years, resident of
______________________________________________
___________________________________________________
District____________________, Odisha, hereby declare that the
information given above and the documents enclosed herewith
containing self certification is/are genuine and authentic. If any
information/document is found to be false/forged/tampered, I shall
personally remain responsible for any criminal action u/s
406/419/420/466/468/471/IPC or any other penal provisions of law
and the authentication of the Certificate will be treated as cancelled
and intimated to all concerned. Also all the benefits availed by me
shall be summarily withdrawn.

Permanent Address Signature of the applicant


Date.
Place.
Mobile No.
E-mail ID.
Present Address

N.B.:- The form is to be signed before an Officer of Home Department, Government of Odisha.
SELF CERTFICATION FOR AUTHENTICATION OF
MARRIAGE/BIRTH/HEALTH CERTIFICATE/AFFIDAVIT/

I Son/daughter of
age about years certify that the Certificate/Affidavit
is genuine and authentic. If the Certificate/Affidavit is found to be
false/forged/tampered, I will be held personally responsible for any
criminal action u/s 406/419/420/466/468/471/IPC and under
appropriate sections of other Acts and Rules and simultaneously the
authentication of the Certificate will be treated as cancelled and
intimated to all concerned.

Permanent Address Signature of the applicant


Date.
Place.
Present Address Mobile No.
E-mail ID.

Reference of two respectable Persons with Mobile No and E-


mail ID:
1.

2.

Photo Copy of Resident Proof and ID :


1. Passport

N.B.:- The form is to be signed before an Officer of Home Department, Government of Odisha.

Common questions

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The self-declaration document establishes personal accountability by requiring the declarant to affirm that their information and enclosed documents are genuine and authentic. It explicitly states that if any document is found to be false, forged, or tampered with, the individual will be personally responsible for any criminal actions under specified sections of the Indian Penal Code (IPC). Additionally, it specifies that the authentication of the certificate will be canceled, and any benefits availed will be withdrawn. This framework compels the declarant to ensure accuracy and truthfulness in their documents or face legal consequences.

Including both permanent and present addresses in the document is important for ensuring accurate identification and contactability of the individual. It allows authorities to confirm the residential status over time and provides multiple points of reference for verification or follow-up procedures, enhancing the thoroughness of the authenticity check.

The role of a Home Department Officer in the authentication process is to serve as an official before whom the self-declaration form is signed. This requirement adds an element of formal oversight and encourages the declarant to provide accurate information, knowing that the document is validated in the presence of an authorized government official.

The document employs self-certification where the applicant declares the authenticity of their information, under penalty of legal action as per various sections of the IPC. Additionally, signing before a Home Department Officer and the provision of references of two respectable witnesses act as mechanisms to encourage accurate disclosure of personal information.

Referencing two respectable persons with contact information serves as an additional verification measure. It allows authorities to verify the identity and credibility of the declarant by consulting third parties who are deemed respectable and presumably trustworthy. This step enhances the reliability of the information provided and provides a means to cross-verify facts if suspicions of forgery or falsehood arise.

Specifying penal provisions in the document acts as a deterrent by making declarants aware of the serious legal repercussions of any falsehoods. Listing specific IPC sections communicates the gravity of document falsification crimes and the readiness of the legal system to prosecute offenders, thereby discouraging individuals from submitting false information.

The document outlines that submitting false, forged, or tampered certificates can lead to personal responsibility for criminal actions under sections 406, 419, 420, 466, 468, and 471 of the IPC, among other applicable laws. These sections cover various offenses related to cheating, forgery, fraud, and impersonation, indicating serious legal consequences for the individual involved.

Contact details such as a mobile number and email ID facilitate communication between the authorities and the declarant. They allow for expedient follow-up or clarification requests and enable authorities to address discrepancies quickly, thereby assisting in a more efficient and effective verification process.

Requiring a photograph can be effective in the verification process as it adds a visual element for personal identification, reducing the risk of impersonation. It serves as tangible proof of the applicant's involvement in the declaration and makes it easier to match the person with their identity, particularly when cross-checked with other government-issued photo IDs.

The self-declaration form ties into India's broader legal framework against document forgery and fraud by invoking specific sections of the IPC that address these issues. Sections such as 406, 419, 420, 466, 468, and 471 IPC relate to cheating, impersonation, and forgery, demonstrating how this document complements existing legal statutes by embedding these sections as a legal deterrent and reinforcing the seriousness of providing accurate documentation.

Annexure-I 
 
 
SELF-DECLARATION FOR AUTHENTICATION OF    
CERTIFICATE 
 
 
I,                      
 
        ,Son/daughter
SELF CERTFICATION FOR AUTHENTICATION OF    
MARRIAGE/BIRTH/HEALTH CERTIFICATE/AFFIDAVIT/ 
 
 
I

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