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Diclaration Form PDF
Diclaration Form PDF
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DECLARATION OF INCOME FOR AVAILING LPG SUBSIDY
Consumer Details
Consumer No
LPG ID
Distributor Details
PAN Details
The information furnished above is correct and I understand that, false information, if any will attracts punishment under Indian
Penal Code.
In case of any revision in my / spouse's income level for subsidy eligibility, I will resubmit the declaration.
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ACKNOWLEDGEMENT SLIP