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🌐 English · Free Income Self-Declaration Affidavit template

Income Affidavit Format (Self Declaration of Income)

Declare your family's annual income from all sources.

Fill in and download - free

Income Self-Declaration Affidavit - sample

Executed on non-judicial stamp paper of Rs. 100/- (value as required by the authority concerned)

AFFIDAVIT FOR INCOME

I, Ramesh Kumar Sharma, son of Mohan Lal Sharma, aged about 35 years, a citizen of India, residing at House no., street, area, city, state - PIN (holding Aadhaar no. XXXX XXXX 4821), do hereby solemnly affirm and state on oath as under:

1.  That I am a major, of sound mind and fully competent to swear this affidavit, and I am the deponent in this matter. I have personal knowledge of the facts stated below, unless I have said that a statement is based on a document or on information.

2.  That my occupation is farming / private job, and I am the head / earning member of my family, which consists of the persons shown in the family record held by me.

3.  That the total annual income of my family from all sources - salary or wages, business or profession, agriculture, rent, interest, pension and any other source - for the financial year 2025-26 is Rs. 1,80,000/- (Rupees One lakh eighty thousand only).

4.  That the above income includes the income of every earning member of the family. No source of income has been left out, and no income has been shown at a lower figure than the actual amount.

5.  That my family does not own income-tax-paying assets, and I have not applied for the same benefit on the basis of any other income certificate, except where I have said so in writing to the authority.

6.  That I have not received, and I am not receiving, the same benefit - scholarship, fee concession, subsidy, ration card or scheme advantage - from any other source for the same period, and I shall not apply for it twice.

7.  That this affidavit is submitted for scholarship application. I understand that the authority may verify my income from the records of the employer, the revenue department, the Income Tax Department or the bank, and I give my consent for that verification.

8.  That I have not concealed any material fact and no part of this affidavit is false. I understand that making a false statement on oath, or using a false affidavit before an authority, is an offence and can lead to penal action and to cancellation of any benefit obtained on its basis.

9.  That I shall produce the original documents referred to in this affidavit for inspection whenever the concerned authority asks for them, and I shall inform the authority at once if any fact stated here changes.

10.  That this affidavit is made in good faith for scholarship application and for no other purpose, and I request the authority to accept it as true.

VERIFICATION

Verified at City on 13/11/2026 that the contents of this affidavit are true and correct to the best of my knowledge and belief, that nothing material has been concealed therefrom and that no part of it is false.

DEPONENT
Ramesh Kumar Sharma

Attestation
Identified by me and solemnly affirmed before me on ____________ at Jaipur by the deponent, who has signed in my presence after the contents were read over and explained to him / her in a language that he / she understands.


Notary Public / Oath Commissioner
Seal and registration no.: ____________

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How to write a Income Self-Declaration Affidavit

  1. Fill in the form: Your full name, Relation, Father's / husband's name, Age (years), Full address, Occupation.
  2. Add your letterhead, logo, footer or watermark if you like.
  3. Download a print-ready PDF - or send it for e-signature.

FAQ

Can an income affidavit replace an income certificate?

Not always. Many schemes need a certificate issued by the tehsildar or revenue office; the affidavit is often a supporting document for that application.

Is there a penalty for a false income declaration?

Yes. A false statement on oath can attract action for false evidence and cancellation of the benefit. Declare figures you can support.

Is this Income Self-Declaration Affidavit template free?

Yes. You can fill it in online and download it as a PDF for free, without installing anything.

Can I change the wording?

Yes. Every sentence of the document can be edited on the page before you download it.

Is this template available in other languages?

Yes - the same document is available in 2 languages. Use the language links on this page.

This is a general template, not legal advice. Check any requirements that apply in your country or organisation.

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