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Example of Self Declaration Form - Templates / Formats

A self-declaration is a statement made by a person declaring that all the statements of facts, figures and circumstances mentioned in a document is true and correct. Unlike an Affidavit, a Self-declaration doesn't necessarily require to be notarized and witnessed, but one may not do it if needed.

In simple words, a self-declaration is a method of double check wherein the person, in a way, swears that he has gone through all the statements made in a document by him and none of them are false. Such self-declaration helps the legal authority, who is verifying the said document, to understand and take a decision on the basis of such statements. 

A self-declaration can be made at the bottom of the ending part of the main document for which such declaration is made or else it can be made as a separate document with reference to the main document.

Following formats are examples of such self-declaration. However, it can be a little more descriptive depending upon the case. Affixing photography of the person making declaration is not mandatory unless it is so required.

SAMPLE #1

SELF DECLARATION

[Photograph
of the Person]

I, (Name of the Person), aged ... years, son / daughter of (Name of the Father), a resident of (Full Residential Address) in the District of ............, (State Name), do hereby declare that the information provided herein above and in the documents appended herewith is true and correct to the best of my knowledge and belief and nothing has been falsely stated or concealed therein. I understand that if the said information as given by me is proved to be false, then I will have to face punishment as per any provision of Law for the time being in force as well as the benefit availed of by me or the benefit accrued to me shall be summarily cancelled.

signature
(Name of the Person)

Date: ..............
Place: .............

*****************************************************************
Sometimes, a self declaration is also given in the form of a verification statement.

SAMPLE #2

VERIFICATION

I, (Name of the Person), son / daughter of (Name of the Parent), aged ...years, currently residing at (Complete Address) in the District of ............, (State Name), do hereby declare and affirm that to the best of my knowledge and belief the statements made herein above are correct, complete and truly stated.

Verified today the ....th day of (Month) in the year of ............

................................
Signature of the person
Place: ..................

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