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SELF DECLARATION OF PARENTS’/ GUARDIAN’S

INCOME
(On Non-Judicial Stamp Paper of Rs.10/-)

I,___________________________________________________ (Parent’s/Guardian) of
________________________________ (Name of the student) who is studying in
_________________________ hereby declare that my annual income from all
source is Rs._____________________(Rs_____________________________________
__________________________________________only).

I,________________________________________ declare that the above


information given by me is true with best of my knowledge to avail the
benefits given to my student and it is found that the information given me
is false, the scholarship amount sanctioned could be withdrawn or
recovered from me and legal action as deemed fit, may be taken against
me or my ward.

Date: Signature of Parent / Guardian

Resident Address

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