You are on page 1of 1

Flat number, Plot No Building Name,

Street Name, Area Name, City Pincode.
Mobile: xxx xxx xxxx • Email:

Self Declaration for Proprietorship

I, Put your name here, (daugther of / wife of, son of) of Put your father/ husband name here

Resident of (City Name, Country) so hereby state and affirm as follows:-

1. I am the sole owner / proprietor of the business operating under the name and style “(Put

your company name here)” operating from (Put your work address here)

2. The business is not undertaken or operated by a partnership firm or limited liability


3. It is also to declare the below mentioned person is my legal nominee for the said

proprietorship concern:-

Name:- (Put your nominee name here)

Relationship with the proprietor:

4. That the contents of this declaration are true and correct to the best of my knowledge and


Signature: Signature of the proprietor with stamp or seal.


Place: Address:

Date: Contact Number: