Print the below income declaration on the Non-Judicial Stamp Paper (Rs.
10/-) INCOME DECLARATION FORM |Name of the Student : | |1. |(i) Name of the Father | | |4. |Business mention the trade/name of business | |-No- | | |(ii) Whether Employed | |-No- | |Income derived from the venture | |-No- | | |(iii) if employed, Designation | |Daily Labour |5. (i) No.
of Vehicles owned by the Family | |Nill | | |(iv) Salary per month | |Rs. 4,000 | |(ii) Whether used for personal/private use only | |-No- | |2. |(i) Name of the Mother | |G. Swarupa | |(iii) Mention type of vehicles (two wheeler/ | |Regd. No.
| | | | | |three wheeler/four wheeler) | | | | |(ii) Whether Employed | |-N0- | |(iv) Vehicle registered on whose name | |-No- | | |(iii) if employed, Designation | |-NO- |6. (i) Type of House: Mention whether RCC, | |Tiled Roofed | | | | | | |thatched/Tiled roofed | | | | |(iv) Salary per month | |-No- | |(ii) Mention whether Indiramma House | |-No- | |3. Agricultural holding of the | |Nill | |(iii) Cost of Construction of House | |-No- | | |parents mention extent | | | | | | | | |(i) In the name of the Father | |-No- | |(iv) Whether Constructed with loan, if so amount| |-No- | | | | | |and Bank Branch | | | | |(ii) In the name of the Mother | |-No- | |(v) Any other type of house | |-No- | |(a) |Crops Grown in land | |-No- |7. (i) Whether living in own house or rented house | |Rented | |(b) |Whether Dry or Wet land | |-No- | |(ii) if rented, mention rent amount | |1200/- | |(c) |Annual Income from Agricultural | |-No- |8 |Telephone / Mobile Number | | | | |Land | | | | | | | | | | | |9. |Total Family income from all sources. | |48,000/- | I hereby declare that the above information given is true & correct.
I will be held liable for any wrong information given which shall include cancellation of scholarship, recovery of amounts paid already if any besides criminal action. Name