FormatsSelf declaration format
Use this general self-declaration when an office or form asks you to declare a fact yourself, such as your address, income or that you hold no other benefit.
Tap a yellow blank and type your own details. What you type stays in your browser only.
SELF-DECLARATION
I, [Your Name], [son/daughter/wife] of [Father's or Husband's Name], aged [Age] years, resident of [Your Address], do hereby declare as follows:
1. [Statement 1, for example that I have been living at the above address since January 2020].
2. [Statement 2].
3. [Statement 3].
I declare that the above information is true and correct to the best of my knowledge and belief, and that nothing has been hidden. I understand that I am responsible for any false statement made here.
Place: [Place]
Date: [Date]
Signature: ____________
Name: [Your Name]
Mobile: [Mobile Number]
स्व-घोषणा पत्र
मैं, [आपका नाम], [पिता या पति का नाम] का पुत्र/पुत्री/पत्नी, आयु [आयु] वर्ष, निवासी [आपका पता], यह घोषणा करता/करती हूँ कि:
1. [कथन 1]।
2. [कथन 2]।
3. [कथन 3]।
मैं घोषणा करता/करती हूँ कि ऊपर दी गई जानकारी मेरी जानकारी और विश्वास के अनुसार सत्य और सही है तथा इसमें कुछ भी छिपाया नहीं गया है। किसी भी असत्य कथन के लिए मैं स्वयं ज़िम्मेदार रहूँगा/रहूँगी।
स्थान: [स्थान]
दिनांक: [दिनांक]
हस्ताक्षर: ____________
नाम: [आपका नाम]
मोबाइल: [मोबाइल नंबर]
Before you send it
- If the office has its own declaration wording, copy that wording exactly. Many schemes print the declaration on the form.
- Write each fact as a separate numbered point.
- A self-declaration is signed by you alone. An affidavit is different: it is sworn before a notary or magistrate, usually on stamp paper. Ask which one the office wants.
- Declare only what is true. A false declaration can lead to rejection and legal action.
This is a general format, written by us, to save you time. If the office concerned has its own printed form, use that form. Last checked: 11 November 2026.
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