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Annexure IV Income Certificate

This is to certify that entire family income of Shri/ Smt…...………………………… (Parent’s Name) Father/ Mother of Mr./Ms…………..……….……………(Student Name) R/o…………………………… ………………………………….is Rs……………… (Rupees….. ………………………………………….) per annum. His/ her present occupation is ……………………… He/ She has no other occupation and income and there is no other earning member in his/ her family.

Place : Date :

Signature with seal and full address of the competent issuing authority

Note : The competent issuing authority shall be as under : i) For salaried employees – The Employer ii) For non-salaried persons living in rural areas – The Patwari/ BDO/ Tehsildar. iii) For non-salaried persons living in urban areas – Tehsildar/ Gazetted Officer/ First Class Magistrate. Attested True Copy Place : Date :

Principal/ Head with Seal