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HOF Address Update Self-Declaration Form

This document is a self-declaration by Shantesh Arora, the Head of Family (HoF), affirming that a family member, Jagruti, resides with him at the specified address and that he agrees to share his address for updating her Aadhaar. It includes a declaration of the accuracy of the information provided and the potential legal consequences for any inaccuracies. The document is valid for three months for Aadhaar address update purposes.

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Shantesh Arora
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2K views1 page

HOF Address Update Self-Declaration Form

This document is a self-declaration by Shantesh Arora, the Head of Family (HoF), affirming that a family member, Jagruti, resides with him at the specified address and that he agrees to share his address for updating her Aadhaar. It includes a declaration of the accuracy of the information provided and the potential legal consequences for any inaccuracies. The document is valid for three months for Aadhaar address update purposes.

Uploaded by

Shantesh Arora
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 FROM THE HEAD OF FAMILY (HOF) FOR SHARING ADDRESS

WITH IMMEDIATE FAMILY MEMBER RESIDING AT THE SAME ADDRESS

I, SHANTESH ARORA
_________________________________________________ (Name as in Aadhaar), resident

of S/O VIJAY ARORA, 139, STREET NO.1, GOPAL NAGAR, MAJITHA ROAD, NEAR PAYAL MEDICOS, MAJITHA ROAD
_________________________________________________________________________

____________________________________________________________________
VTC: Amritsar -I, PO: Amritsar G.P.O, District: Amritsar, State: Punjab, PIN Code: 143001 (Address
5418 1069 9108
as provided in Aadhaar) holding Aadhaar Number___________________________________, do

hereby solemnly affirm and declare as under:-

i. JAGRITI
That resident Mr./Ms._____________________________ holding Aadhaar number
2190 9777 2513
_______________________ WIFE
is related to me as my __________________________

___________________________ (Please specify the relation with applicant) and is

residing with me at the above mentioned address.

ii. JAGRITI
That I agree to share my address in my Aadhaar with Mr./Ms. __________________

_____________________ for updating his/her address in Aadhaar in my capacity of

Head of the Family (HoF).

iii. That the undersigned undertakes that, the above mentioned information is correct

to the best of my knowledge and belief and at any point of time if any of the said

information is found to be incorrect/fraudulent/false, the Aadhaar of Mr./Ms.


JAGRITI
___________________________ and mine can be deactivated and legal action

may be initiated against me, as per the provisions of the Aadhaar (Targeted Delivery

of Financial and Other Subsidies, Benefits and Services) Act, 2016 (18 of 2016) and,

Regulations framed there under and other applicable Acts and Rules, etc.

Shantesh Arora
02/05/2025
 Name & Signature of Head of the Family (HoF)

Note:
1. This document is valid for Head of Family (HoF) based Aadhaar address update purpose only.
2. This document is valid for 3 months from date of issue

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