UNDERTAKING

This is certify that the under mentioned particulars are correct and true solemnly declare that the documents submitted by me are true and details is given as under: –

NAME                                               :    _________
FATHER’S NAME                         :    _________
RESIDENTIAL ADDRESS          :    _________
CATEGORY                                     :    OLD AGE
ELIGIBILITY                                 :    MY AGE IS _________

This is also certify that I have no source of incomes and direly need of pension recommended by the _________  and I have not applied/not taking any pension from any Organization i.e. _________  Government/Central Government /any _________  except this pension I am also residing _________  for more than _________  years.

All the above details are true and correct and nothing has been concealed if any instant is noticed in this regards i will be fully responsible for the same.

APPLICANT