Self declaration format

Use this general self-declaration when an office or form asks you to declare a fact yourself, such as your address, income or that you hold no other benefit.

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SELF-DECLARATION I, [Your Name], [son/daughter/wife] of [Father's or Husband's Name], aged [Age] years, resident of [Your Address], do hereby declare as follows: 1. [Statement 1, for example that I have been living at the above address since January 2020]. 2. [Statement 2]. 3. [Statement 3]. I declare that the above information is true and correct to the best of my knowledge and belief, and that nothing has been hidden. I understand that I am responsible for any false statement made here. Place: [Place] Date: [Date] Signature: ____________ Name: [Your Name] Mobile: [Mobile Number]

When to use this paper

Use a self-declaration when a form, scheme or office asks you to state a fact on your own responsibility and has not given its own wording. It is used for simple facts that you know first-hand. Where the office asks for an affidavit, a self-declaration will not be accepted in its place, so check which of the two is wanted.

Before you send it

If the office has its own declaration wording, copy that wording exactly. Many schemes print the declaration on the form.
Write each fact as a separate numbered point.
A self-declaration is signed by you alone. An affidavit is different: it is sworn before a notary or magistrate, usually on stamp paper. Ask which one the office wants.
Declare only what is true. A false declaration can lead to rejection and legal action.

How to send or submit it

Print it, fill it in, sign it with the date and place, and submit it with the main application and the supporting papers the office lists. On an online portal you may be asked to upload a signed scan. Keep a copy: you are responsible for what it says.

Mistakes that get it sent back

The office had its own declaration text and a different one was submitted.
Unsigned, undated, or signed by someone other than the person declaring.
Facts in the declaration do not match the application form or the attached documents.
Corrections and overwriting. Print a fresh copy if you make a mistake.

This is a general format, written by us, to save you time. If the office concerned has its own printed form, use that form. Last checked: 11 November 2026.

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