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Appendix III

(Specimen)

DECLARATION OF PARENT’S/GUARDIAN’S INCOME

I Sabu parent/guardian of Faris who is studying in


Chempakassery HSS-XI Commerce B here by declare that
my annual income from all sources is Rs.1800/-(One
thousand eight hundred ) only.
If any stage, it is found that the information given by me is
false/not true, all benefits given to the student under the
scheme of “Post-metric scholarship for students belonging to
minority communities” could be withdrawn and legal action as
deemed fit, may be taken against me or my ward.

Date:16/08/2010 Signature
Father/Mother/guardi
an

Pallathil
Vadakkethil.
Bhoothakkulam-P.O
Kollam-Dt.

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