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Income self-declaration format
A signed statement of your family's yearly income. Offices ask for it with an income certificate application, and sometimes for schemes and scholarships.
This is a sample, not an official form. Offices and states differ. Check this text with the issuing office before you sign, and use the office's own form if it gives you one. Govt License does not give legal advice.
What it is for
Use it when the income certificate application or a scheme asks for a self-declaration of income, for example when you have no salary slip or ITR.
Who signs
The applicant signs. Some offices also want a ward member, sarpanch or other official to confirm the income.
Used for
Attach these
- ID and address proof
- Ration card or family details
- Salary slip, ITR or land record, if you have them
Fill in the blanks
Type in the boxes and the sample updates. Anything you leave empty stays a blank line you can write by hand after printing. Nothing you type is sent anywhere.
SELF-DECLARATION OF INCOME
I, ________, son, daughter or wife of ________, aged ________ years, resident of ________, do hereby declare as follows:
1. The total yearly income of my family from all sources in the financial year ________ was Rs. ________ (Rupees ________ only).
2. The sources of this income are: ________.
3. The family members whose income is included are: ________.
4. I am giving this declaration for the purpose of ________.
5. The above information is true and correct. I understand that if it is found to be false, the certificate or benefit can be cancelled and action can be taken as per law.
Date: ________
Place: ________
Signature: ______________________
Name: ________
Common questions
Is a self-declaration enough to get an income certificate?
The income certificate is issued by the state revenue office, which may verify the income. The declaration is one of the papers. Read the Income certificate page on this site for your state.
Which income should I show?
Show the total family income from all sources for the year the office asks about. Be honest. A false statement can cancel the certificate.
Does it need a notary?
Usually it is signed on plain paper. If the office asks for an affidavit, get it notarised.
Aksar pooche jaane wale sawaal
Yahi jaankari, Hinglish mein.
Aay praman patra (income certificate) ke liye self declaration kaise likhein?
Is page ka format copy karein, saal ki kul family income aur uske source bharein, print nikalein aur sign karein. Sahi aay hi likhein, galat jaankari par certificate cancel ho sakta hai.
Kya self declaration se income certificate mil jata hai?
Income certificate rajasv vibhag deta hai aur wo jaanch kar sakta hai. Declaration ek zaroori kagaz hai. Apne state ka income certificate page dekhein.