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Income self-declaration format
A signed statement of your family's yearly income. Offices ask for it with an income certificate application, and sometimes for schemes and scholarships.
What it is for
Use it when the income certificate application or a scheme asks for a self-declaration of income, for example when you have no salary slip or ITR.
Who signs
The applicant signs. Some offices also want a ward member, sarpanch or other official to certify the income.
Licences that need this format
Attach these
- ID and address proof
- Ration card or family details
- Salary slip, ITR or land record, if you have them
Fill it in, then download
Fill in the form. The document on the right changes as you type. Download it as Word or PDF, print it, or copy the text. Nothing is sent anywhere.
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 INCOME
I, ________________________, resident of ________, do hereby declare as follows:
1. The total yearly income of my family from all sources in the financial year ________ was ________.
2. The sources of this income are: ________.
3. The family members whose income is included are: ________.
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, the certificate or benefit can be cancelled and action can be taken as per law.
Date: ________
Place: ________
Signature: ______________________
Name: ________
आय का स्व-घोषणा पत्र
मैं, ________________________, निवासी ________, एतद्द्वारा घोषणा करता/करती हूँ कि:
1. वित्तीय वर्ष ________ में सभी स्रोतों से मेरे परिवार की कुल वार्षिक आय ________ थी।
2. इस आय के स्रोत हैं: ________।
3. जिन परिवार के सदस्यों की आय शामिल है वे हैं: ________।
4. मैं यह घोषणा ________ के उद्देश्य से दे रहा/रही हूँ।
5. उपर्युक्त जानकारी सत्य और सही है। मैं समझता/समझती हूँ कि यदि यह झूठी पाई गई तो प्रमाण पत्र या लाभ रद्द किया जा सकता है और कानून के अनुसार कार्रवाई की जा सकती है।
दिनांक: ________
स्थान: ________
हस्ताक्षर: ______________________
नाम: ________
வருமானச் சுய உறுதிமொழி
நான், ________________________, ________ என்ற முகவரியில் வசிப்பவர், இதன் மூலம் பின்வருமாறு அறிவிக்கிறேன்:
1. நிதியாண்டு ________ இல் அனைத்து வழிகளிலிருந்தும் எனது குடும்பத்தின் மொத்த ஆண்டு வருமானம் ________ ஆகும்.
2. இந்த வருமானத்தின் ஆதாரங்கள்: ________.
3. வருமானம் சேர்க்கப்பட்டுள்ள குடும்ப உறுப்பினர்கள்: ________.
4. இந்த அறிவிப்பை ________ நோக்கத்திற்காகத் தருகிறேன்.
5. மேற்கண்ட தகவல் உண்மையானது, சரியானது. இது பொய்யானது எனக் கண்டறியப்பட்டால் சான்றிதழ் அல்லது பலன் ரத்து செய்யப்படலாம் என்பதையும் சட்டப்படி நடவடிக்கை எடுக்கப்படலாம் என்பதையும் புரிந்துகொள்கிறேன்.
நாள்: ________
இடம்: ________
கையொப்பம்: ______________________
பெயர்: ________
SELF-DECLARATION OF INCOME
I, ________________________, resident of ________, do hereby declare as follows:
1. The total yearly income of my family from all sources in the financial year ________ was ________.
2. The sources of this income are: ________.
3. The family members whose income is included are: ________.
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, the certificate or benefit can be cancelled and action can be taken as per law.
Date: ________
Place: ________
Signature: ______________________
Name: ________
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: The applicant signs. Some offices also want a ward member, sarpanch or other official to certify the income.
- 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
Is a self-declaration enough to get an income certificate?
Which income should I show?
Does it need a notary?
Who signs an income self-declaration?
What documents go with the income self-declaration?
When do I need an income self-declaration?
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