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INCOME DECLARATION FORM

    Name of the Student:
1.  (i) Name of the Father
    (ii) Whether Employed
    (iii) if employed, Designation
    (iv) Salary per month
2.  (i) Name of the Mother
    (ii) Whether employed
    (iii) if employed, Designation
    (iv) Approx salary per month
3.  Agricultural holding of the parents
    mention extent
    (i) In the name of the Father
    (ii) In the name of the Mother
(a) Crops Grown in land
(b) Whether Dry or Wet land
©   Annual income from Agricultural
    Land
4.  Business mention the trade/name
    of business
    Income derived from the venture
5.  (i) No. of Vehicles owned by
    the Family (ii)Whether used for
    personal/private use only

     (iii) Mention type of vehicles(two   Regd.No.
     wheeler/        three wheeler/four
     wheeler)

     (iv) Vehicle registered on
     whose name
6.   (i)Type of House: Mention
     whether RCC, thatched/ Tiled
     roofed
     (ii) Mention whether
     Indiramma House
     (iii) Cost of Construction   of
     House
     (iv) whether constructed with
     loan, if so amount and Bank
     Branch
     (v) Any other type of house
7    (i) Whether living in own house
     or rented house
     (ii) if rented, mention rent
     amount
8.    Telephone/Mobile Number
9.   Total Family income from all
     sources




Name & Signature of the Student           Name & Signature of the Parent



ePASS Application ID of student:


Date:-                                                   Date:
Place:-                                                  Place:-

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Income declaration form

  • 1. INCOME DECLARATION FORM Name of the Student: 1. (i) Name of the Father (ii) Whether Employed (iii) if employed, Designation (iv) Salary per month 2. (i) Name of the Mother (ii) Whether employed (iii) if employed, Designation (iv) Approx salary per month 3. Agricultural holding of the parents mention extent (i) In the name of the Father (ii) In the name of the Mother (a) Crops Grown in land (b) Whether Dry or Wet land © Annual income from Agricultural Land 4. Business mention the trade/name of business Income derived from the venture 5. (i) No. of Vehicles owned by the Family (ii)Whether used for personal/private use only (iii) Mention type of vehicles(two Regd.No. wheeler/ three wheeler/four wheeler) (iv) Vehicle registered on whose name 6. (i)Type of House: Mention whether RCC, thatched/ Tiled roofed (ii) Mention whether Indiramma House (iii) Cost of Construction of House (iv) whether constructed with loan, if so amount and Bank Branch (v) Any other type of house 7 (i) Whether living in own house or rented house (ii) if rented, mention rent amount 8. Telephone/Mobile Number 9. Total Family income from all sources Name & Signature of the Student Name & Signature of the Parent ePASS Application ID of student: Date:- Date: Place:- Place:-