Scribd
Upload
47 views1 page

Self-Declaration for Pension Eligibility

This self-declaration form affirms that the applicant does not have children employed in government or private sectors, does not own large businesses or automobiles, and does not possess land exceeding specified limits. The applicant acknowledges that if any information is found to be false, they agree to the cancellation of their pension and will return any received amounts. The declaration is signed and dated by the applicant.

Uploaded by

workshopnaplngr
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
47 views1 page

Self-Declaration for Pension Eligibility

This self-declaration form affirms that the applicant does not have children employed in government or private sectors, does not own large businesses or automobiles, and does not possess land exceeding specified limits. The applicant acknowledges that if any information is found to be false, they agree to the cancellation of their pension and will return any received amounts. The declaration is signed and dated by the applicant.

Uploaded by

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

SELF DECLARATION

I,……………………….……………….………………….,
S/O,D/O,W/O................................................................,

Age:…….….., year……………..Resident of [Link]……………..………………………… , nagaur district,

rajasthan State, INDIA, (Aadhar Card No……………………..……..………….) do hereby solemnly


affirm

and state on oath as under:

1. I am not having children who are Govt. Employee / Private sector employment /
Private / Outsourced / Govt. Pensioner / Freedom Fighter pension.

2. I am not having large business Enterprise like oil mills, rice mills, petrol pumps,
rig owners, shop owner etc.

3. I am not Owners of light and/or heavy automobiles (four wheelers and big vehicles.)

4. I am not having land more than 3.0 acres wet/irrigated dry or 7.5 acres dry.

5. I am not any other criterion in which the verification officer may assess by the
manner of lifestyle, occupation and possession of assets rendering the
households as ineligible.

That the above facts are true in future if it is proved false I have no objection if my

sanctioned pension is cancelled more over I shall return all the pension amount which I

obtained from the Government by my false representation.

Date:-
……………………………
Signature of the applicant / Thumb

impression Mobile No.

…………………………………………

You might also like