Income Certificate Self-Declaration Affidavit

Sworn income declaration affidavit format for college scholarships, government welfare schemes, EWS reservations, and ration card applications.

Statutory Governing Law

State Revenue Department guidelines & Oaths Act 1969.

Stamp Duty & Registration Rule

Executed on ₹10 or ₹20 Non-Judicial Stamp Paper and attested by a Notary Public or Executive Magistrate.

Standard Format Preview & Editor(Replace bracketed text like [NAME] with actual facts)

BEFORE THE NOTARY PUBLIC / TEHSILDAR AT [CITY, STATE]

DECLARATION & AFFIDAVIT FOR INCOME CERTIFICATE

I, [APPLICANT_NAME], Son/Daughter/Wife of [FATHER/SPOUSE_NAME], aged [AGE] years, residing at [PERMANENT_ADDRESS], Aadhaar No: [AADHAAR_NO], do hereby solemnly affirm and declare as follows:

1. That I am the head / earning member of the family residing at the above address.
2. That my occupation is [OCCUPATION / TRADE, e.g. Small Retail / Agriculture / Freelancer].
3. That my total family income from all sources (including agricultural produce, business, and interest) for the financial year [YEAR-YEAR] is Rs. [ANNUAL_INCOME]/- (Rupees [INCOME_IN_WORDS] only).
4. That no other family member has any independent taxable income.
5. That this affidavit is submitted before the Tehsildar / Sub-Divisional Magistrate for the issuance of an Income Certificate for [PURPOSE, e.g., Post-Matric Scholarship / EWS Quota / Fee Concession].

DEPONENT

VERIFICATION:
Verified at [CITY] on [DATE] that the contents of this declaration are true to my personal knowledge. If found false, I shall be liable for prosecution under Indian Penal Code / Bharatiya Nyaya Sanhita.

DEPONENT

💡 Tip: Paste into Microsoft Word or Google Docs to format into paragraphs and print on legal paper.Get advocate stamped version

Essential Clauses in this Standard Draft

Head of Family / Applicant Particulars

Breakup of Income from Agriculture, Business & Employment

Total Annual Household Income Declaration

Penalty Warning under Section 199/200 IPC for False Affidavit

Verification before Notary

Advocate Review & Official E-Stamp

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Frequently Asked Questions about Income Certificate Self-Declaration Affidavit

What is the validity period of an Income Certificate?

Income certificates issued by state revenue departments are generally valid for one financial year (April 1 to March 31).