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Income Declaration Form for Odisha

This document is a self-declaration of occupation and income form. It requires the declarant to provide details about their occupation, income sources, and income amounts. It also states that false declarations can result in penal action.

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Shankar Gowri
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0% found this document useful (0 votes)
135 views1 page

Income Declaration Form for Odisha

This document is a self-declaration of occupation and income form. It requires the declarant to provide details about their occupation, income sources, and income amounts. It also states that false declarations can result in penal action.

Uploaded by

Shankar Gowri
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 OF OCCUPATION AND INCOME

(To be certified and attested before a Gazetted Officer of the State Government)

I, Smt. _______________________________________ wife/daughter of _____________________


major of age, resident of ______________________ do hereby solemnly declare as under: 1. I say
and declare that, presently I am working/self-employed as _______________ /not working/
housewife/home-maker (strike out whichever not applicable), and my monthly salary/income is Rs.
_______________ (Rupees ________________________________________________only).

2. I say and declare that, my husband is presently working/self-employed as _______________ /not


working (strike out whichever not applicable), and my monthly salary/income is Rs. _________
(Rupees ___________________ ___________________only).

3. I say and declare that me and my husband are not employed in any of the following entities on
regular basis. (i) Government of Goa or its’ Corporation or Autonomous organization funded by State
Government. (ii) Government of India or any other State Government or its Corporations/Autonomous
bodies. (iii) Scheduled Banks but excluding Co-operative banks (subject to actual income in case of
Co-operative Banks).

4. I say and declare that my annual income from all sources does not exceed Rs.________________
(Rupees _____________________________________only). (a) Income from agriculture sources
Rs.______________. (b) Income from Bank deposits : Rs. ________________. (c) Income from other
sources : Rs. ___________________. (d) Income of husband (if applicable): Rs. _________________.

5. I say and declare that the present self-declaration is produced in the Office of Directorate of Women
& Child Development, Government of Goa, for availing the financial assistance under the GRIHA
AADHAR SCHEME.

6. I say and declare that the above contents are true to the best of my knowledge and nothing false has
been stated.

7. I say and declare that, in the event of any false declaration I shall be held responsible and shall be
liable for penal action as deemed fit against me including filing criminal case.

Solemnly declared at _______ on this _______ day of the month of ______ of the year ________.

(SIGNATURE OF THE DECLARANT)

Signed before me and attested:

Signature : _____________________

Name & Designation of the Gazetted Officer : ______________

Address : _____________________

Seal

Common questions

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The self-declaration form requires applicants to provide a breakdown of their annual income, listing separate sources such as agriculture, bank deposits, other sources, and the husband's income if applicable. This detailed reporting mechanism helps in accurately assessing total income and determining eligibility .

An individual or their spouse will be disqualified from financial assistance under the GRIHA AADHAR SCHEME if they are employed on a regular basis with the Government of Goa, its corporations or autonomous organizations funded by the State Government, the Government of India or any other State Government or its Corporations/Autonomous bodies, or in Scheduled Banks (excluding Co-operative banks, subject to actual income from these banks).

The self-declaration document directly addresses the issue of dual employment by requiring declarants to affirm that neither they nor their spouse are employed on a regular basis with any government entity or scheduled banks, which could disqualify them from the scheme. This stipulation ensures that applicants are genuinely eligible and are not benefitting from regular salaried positions that contradict the scheme's requirements .

The self-declaration form aligns with government objectives by ensuring that financial support is distributed to genuinely eligible individuals who are not beneficiaries of regular salaries or have significant incomes from excluded sources. This helps to direct resources towards those who truly need aid, thereby fulfilling the scheme's objective of supporting women who are economically vulnerable .

It is necessary to certify income from different sources to provide a clear and comprehensive picture of the applicant's financial situation. This ensures that the applicant is transparently reporting all potential income streams, which is vital for determining eligibility for financial assistance under the scheme .

The Gazetted Officer plays a crucial role in the self-declaration process by certifying and attesting the declaration, thereby verifying the authenticity of the document. This official endorsement is crucial for maintaining the integrity and credibility of the application process and ensuring that declarations comply with regulatory standards .

The procedural elements necessary for the self-declaration to be valid include having the declaration certified and attested by a Gazetted Officer of the State Government, which adds a layer of official verification to the claims being made. This requirement is critical for ensuring the integrity of the application process and adds an element of external accountability .

The consequences for providing false information in the self-declaration form include being held responsible and liable for penal actions as determined appropriate, such as the filing of a criminal case against the declarant .

The self-declaration form ensures accountability and prevents fraudulent claims by requiring individuals to affirm that the contents are true to the best of their knowledge, and it explicitly states that false declarations will result in penal action, including the possibility of criminal prosecution .

The income components considered in the self-declaration for the GRIHA AADHAR SCHEME include income from agricultural sources, bank deposits, other sources, and the income of the husband if applicable. The total annual income from all these sources must not exceed a certain limit to qualify for assistance under the scheme .

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