AFFIDAVIT

I _________ son/daughter/wife of _________ resident of _________ do hereby solemnly affirm and declare as under :
1.    That I am citizen of _________ and I am holding _________ bearing No. _________.
2.    That my _________.
3.    The following members of the family reside with me and their personal annual income is as under:

Sr. No.	Name	Age/Birth Year	Relationship	Annual Income
1.
2.

4.    That my total annual income of all my family members from all resource is _________  only.
5.    That I am not a Government Servant and  I am not a Grade __ employee of the Central Government State Government /Semi Government /Public Sector Unit Autonomous Institutions.

DEPONENT

VERIFICATION:
Verified at _________ on this _________ , _________ on Solemn affirmation that the contents of my above affidavit are true and correct to the best of my knowledge, no part of it false and nothing has been concealed therefrom.

DEPONENT

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• Affidavit for Ration Card
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• Ration Card Application