Declaration of Rent paid

(for the amount of rent paid less than Rs.3000/- per month)

I, ___________________________________________________________ hereby declare that

I am paying Rent of Rs._______ (in words__________________________________________)

per month to the address________________________________________________________

____________________________________________________________________________

_________________________________________________at where I am staying for as Tenant.

My House owner's name and address are given below;

Landlord's Name:_________________________
Address: Signature
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Employee Name:
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----------------------------------------- PAN No:
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