DECLARATION FORM - IIT Kanpur
DECLARATION FORMI, ________________________________________ _ hereby declare that following are the members of myfamily who are residing with me and are wholly dependent upon OF MEMBERS OF FAMILY:Sl. in FullDate of BirthRelationshipThe particulars of dependent members of my family as given above are correct. If any statement is found tobe untrue I shall be liable for disciplinary action. _________________________________ (Signature of student)Name: ____________________________________Roll No. :________________________________House No.:_________________________________Dat e:____________________Forwarded_________ _________(Signature of the Head)(with Seal)
DECLARATION FORM I, _____ hereby declare that following are the members of my family who are residing with me and are wholly dependent upon me.
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