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Address proof self-declaration format

A signed statement of where you live, for people who do not have a bill or rent agreement in their own name, for example people living with family or in a rented room.

This is a sample, not an official form. Offices 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 an office accepts a self-declaration of address, or when you live with a relative and need their consent letter along with your own declaration.

Who signs

You sign. If you live at someone else's address, that person signs the consent line too.

Licences that need this format

Attach these

  • Your ID proof
  • The host's address proof and ID copy, if you live with a family member or friend
  • Any other address proof you have

Fill it in, then download

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Where will you sign this?
The state and city change the laws and offices named in your document and in How to execute.
Declarant
Printing

Ready-to-use template based on current law. For property sale, partnership or high-value agreements, get it checked by an advocate before signing.

Last reviewed: 30 Oct 2026

Preview. Blanks you have not filled in are highlighted in yellow on screen, and print as plain lines.

SELF-DECLARATION OF ADDRESS

I, ________________________, declare as follows:

1. My present address is: ________.

2. I have been living at this address since ________.

3. I do not have a document in my own name that shows this address. The house belongs to ________, who is my ________, and I live there with permission.

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, my application can be rejected and action can be taken as per law.

Date: ________
Place: ________

Signature of declarant: ______________________
Name: ________

CONSENT OF THE HOUSE OWNER OR HOST
I, ________, confirm that the above person lives at the above address with my permission. A copy of my ID proof is attached.

Signature: ______________________

How to execute this document

  • Stamp paper: Plain paper is usually enough. Use stamp paper only if the office that receives it asks for it.
  • Notarisation: Not needed unless the office asks for it.
  • Registration: Not needed.
  • Who signs: You sign. If you live at someone else's address, that person signs the consent line too.
  • Witnesses: none needed unless the office asks.
  • ID and photos: Carry an original ID of the person who signs. Never write an Aadhaar number on the document.
  • Where to submit: The office or portal that asked for it, together with the other documents in the checklist.

Common mistakes

  • No date or signature.
  • No copy of the signer's ID attached.
  • Sending an unsigned copy.

Common questions

Will every office accept a self-declaration of address?
No. Some accept it, some do not. Many ask for one of their listed proofs, such as a bill or Aadhaar. Check the list for the document you are applying for.
Do I need the host's papers too?
Often yes. A copy of the host's ID and a recent bill or property paper makes the declaration stronger.
Does it need a notary?
Usually it is on plain paper. If the office asks for an affidavit instead, use the residence affidavit format and get it notarised.

Aksar pooche jaane wale sawaal

Yahi jaankari, Hinglish mein.

Address proof na ho to self declaration kaise likhein?
Is page ka format copy karein, apna pata aur kab se rah rahe hain bharein, aur jiske ghar mein rah rahe hain unka consent sign karwayein. Saath mein unka ID aur bill ki copy lagayein.
Kya har office self declaration of address maanta hai?
Nahi. Kuch maante hain, kuch nahi. Jis document ke liye apply kar rahe hain uski address proof list dekhein.