SELF DECLARATION OF FAMILY INCOME

I, ______________ ____________Father/Mother( in case of single

parent) of _______________ __________, resident of ( full
address) ____________________________________________
________________________________________________________
________________________________________________________
hereby declare as under :

a) I am Citizen of India.
b) That annual family income from all sources is Rs. ____________
( in words also)_________________________________________.
c) I declare that I /my spouse /both is/are earning member(s) in my
family.
2. I certify that the above information given by me is true.
3. In case this information is found false , the financial assistance awarded
to me may be recovered with penality interest and I am liable to a legal
action against me in accordance with law.

Signature of Parent.

Note: For SC/ST/OBC/Min Students