Declaration of accommodation

I, CPR No:
Hereby declare in my capacity as the head of the family or owner or tenant of the property, that
the individuals whose details provided herein are residing with me in the address as stated
below. I agree to hold the sole responsibility upon them for the purpose of any enquiry about
them or their place of residence, or in the event that any data l provided herein are false or
inaccurate. My undertaking, however, shall not extend to matters related to or arise from any
official documents of those people bearing any address other than as stipulated below:

Address:
FLAT: BUILDIN: AVE/ROAD/LANE: _BLOCK: _
NO. NAME RELATION CPR NO.
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Signature: -------------------------------------------------------
Date -----/------/-------------