I, YOUR NAME S/o.

YOURFATHERSNAME, aged about YOURAGE years, Occ: YOUROCCUPATION

R/o. H.No.RESIDENTIAL ADDRESS INCLUDING HOME STATE CITY PINCODE, do hereby solemnly affirm
and state on oath as follows:

That I am the deponent herein as such I am well acquainted with the facts of this affidavit

That I am residing along with my family at the above mentioned address i.e. H.No.RESIDENTIAL
ADDRESS INCLUDING HOME STATE CITY PINCODE, since NUMBEROFYEARS years and the same is our
residential address for all practical purposes.

That I am working as an OCCUPATION and getting a monthly income of Rs.MONTHLY INCOME/-

and my annual income from all sources is Rs. YEARLY INCOME/-.

That I require “income certificate” from the Mandal Office, in favour of my son YOURSONSNAME
for his higher studies.

That what all state above is true and correct to the best of my knowledge and belief hence this
affidavit

Sworn and signed before me on this the 9th day of September, 2009 at CITY.

(YOUR SIGNATURE)

DEPONENT

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