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    Form "D" Indian Institute of Technology Delhi: Family Income Statement

    Uploaded by

    Rohan
    This document contains forms and guidelines for students to submit family income information and income certificates. It includes: 1) A form titled "Family Income Statement" that collects information on the student and their family members' sources of income and total annual income. 2) Guidelines on the required supporting documents for different income sources such as income tax returns, income certificates, and BPL cards. 3) A format for an "Income Certificate" signed by a government revenue officer declaring the annual income of the student's family from various sources including employment, business, property, investments and others.

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    Form "D" Indian Institute of Technology Delhi: Family Income Statement

    Uploaded by

    Rohan
    35 views2 pages
    This document contains forms and guidelines for students to submit family income information and income certificates. It includes: 1) A form titled "Family Income Statement" that collects information on the student and their family members' sources of income and total annual income. 2) Guidelines on the required supporting documents for different income sources such as income tax returns, income certificates, and BPL cards. 3) A format for an "Income Certificate" signed by a government revenue officer declaring the annual income of the student's family from various sources including employment, business, property, investments and others.

    Original Description:

    Nyce h

    Original Title

    FORM-F-G

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    This document contains forms and guidelines for students to submit family income information and income certificates. It includes: 1) A form titled "Family Income Statement" that collects information on the student and their family members' sources of income and total annual income. 2) Guidelines on the required supporting documents for different income sources such as income tax returns, income certificates, and BPL cards. 3) A format for an "Income Certificate" signed by a government revenue officer declaring the annual income of the student's family from various sources including employment, business, property, investments and others.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    35 views2 pages

    Form "D" Indian Institute of Technology Delhi: Family Income Statement

    Uploaded by

    Rohan
    This document contains forms and guidelines for students to submit family income information and income certificates. It includes: 1) A form titled "Family Income Statement" that collects information on the student and their family members' sources of income and total annual income. 2) Guidelines on the required supporting documents for different income sources such as income tax returns, income certificates, and BPL cards. 3) A format for an "Income Certificate" signed by a government revenue officer declaring the annual income of the student's family from various sources including employment, business, property, investments and others.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    Form

    Form “D”
    F

    INDIAN INSTITUTE OF TECHNOLOGY DELHI

    FAMILY INCOME STATEMENT

    NAME OF THE STUDENT________________________ ENTRY NO. ___________________________

    PROGRAMME _________________________________ALL INDIA RANK_______________________

    CATEGORY _________________________________CATEGORY RANK ______________________

    HOSTEL ALLOTTED ____________________________STUDENT’S MOBILE NO.________________

    AADHAR No.___________________________________ PAN No.______________________________

    FAMILY ANNUAL INCOME


    Source of Income Total Annual
    Income
    a Father Aadhar No PAN No.
    Self employed /
    Service
    Other (Pl. specify)____________
    b Mother
    Self employed /
    Service
    Other (Pl. specify) ___________
    c Any other
    Family Income
    Grand Total

    Supporting Documents to be submitted:

    Salaried Income Tax Return (ITR)/ Form-16 and Copy of Aadhar and PAN
    Self Employed Income Tax Return (ITR)/ Income Certificate and Copy of Aadhar and PAN
    BPL card holders Attested copy of the BPL card and Copy of Aadhar and PAN

    Income Certificate should be duly signed by a First Class Magistrate/ S.D.O./B.D.O/TEHSILDAR of the district of
    residence. Income Certificate signed by Notary/Oath Commissioner will NOT be accepted.

    (SIGNATURE OF THE STUDENT) (SIGNATURE OF THE PARENT/GUARDIAN)

    ***********
    INCOME DECLARATION

    The declaration of the Gross Annual family Income is a must for students seeking Institute scholarships and any other
    Donor scholarship. For this purpose, income certificate is to be submitted by the Parent(s) whether in
    business/employment or in service with Private/Government organization.

    The income certificate should be duly signed ON ALL PAGES by a First Class Magistrate/ S.D.O./B.D.O/TEHSILDAR
    of the district of residence. Income Certificate signed by Notary/Oath Commissioner will NOT be accepted.
    -------------------------------------------------------------------------------------------------------------------------------------

    (FORMAT OF INCOME CERTIFICATE) Form G

    Name of Student: …………………………………………………….Entry No ……………………………..


    Programme Name ………………………………………………………Cat(Gen/OBC/SC/ST/PD………..
    (B.Tech in ….. or Dual Degree in ….. …)

    I,……………………………………….., father/mother/guardian of Mr./Ms.......…..……………………….


    declare that my/our annual income from all sources e.g. service/ agricultural/ trading/ pension/
    interest/ …………………………… (specify all types of other sources) including that of my spouse
    and unmarried children is Rs……………………(Rupees ……..………………….……………..….……
    only). The details are as follows:

    (A) 1. From my profession/ Salary/ pension as indicated Rs._______________________p.a.


    (Attach proof from employer/ Form 16/ IT Return etc.)
    2. Income from Business/ Medical Practice Legal Practice/ Engineering Consultancy etc.
    Rs._______________________p.a.

    3. Income from Agriculture Rs._______________________p.a.


    4. Income from land Properties Rs._______________________p.a.
    5. Income from Investment in Bank/ Post Office etc Rs._______________________p.a.
    6. Income from Share Certificate/ Debentures Rs._______________________p.a.
    7. Income from any other sources
    (i.e. Retirement Benefits for VRS/ VSS etc. if any) Rs._______________________p.a.

    (B) Income of my wife/ husband (if any) Rs._______________________p.a.


    (if employed salary certificate employer / Form 16 to be enclosed)

    (C) Income in the name of my son/ daughter Rs._______________________p.a.

    GROSS TOTAL INCOME (A+B+C) Rs._______________________p.a.

    Further I declare that the information given above is true. I understand that the Merit-cum Means
    Scholarship/Freeship/Free Messing/Scholarship, if awarded to my son/ daughter, is liable to be withheld or
    discontinued at the discretion of the authorities of the Indian Institute of Technology Delhi without assigning
    any reason. If subsequently (after award of the Scholarship to my ward) it is found that he/she has been
    granted any other Scholarship/ Stipend/ Fin. Assistance etc. by any Govt./ Non-govt. organisation for the
    same period, I shall be bound to refund the whole amount of Scholarship / Stipend/ Financial Assistance etc.
    to the scholarship awarding authority immediately. I shall also be personally held responsible for the refund of
    the Scholarships amount (paid to my son/ daughter by the Institute) in the event of any information in this
    declaration being found incorrect/ false later on.
    _________________________
    (Signature of Father/Guardian)

    Sworn before me this _________________ day of ____________________ 201_ and signed.

    (SEAL with date) _______________________________________


    Signature of First Class Magistrate/ S.D.O./B.D.O./ TEHSILDAR
    or any other Revenue officer of the district of the signatory.
    ************
    Note: The students are advised to keep a photocopy of the Income Certificate submitted at IIT Delhi for future reference.

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