DISTRICT ARUNACHAL PRADESHI declare that the particulars furnished above are true to the best of my knowledge and belief.Signature of the Applicant1. Name in full ( In block letter )2. Father's Mother's Guardian's Husband Name3. Present Occupation4. Village5. Circle6. For whom the certificate is required7. Total number of family members8. Income per annum with supporting affidavit 9. (a) Other Land holding (b) Other Sources TOTAL PER ANNUM10. Schedule cast Schedule tribe11. Purpose for which certificate is soughtPublished on National Portal of India (india.gov.in) Application form for obtaining Income Certificate from theDeputy CommissionerfromHODDDORs/- VERIFICATIONI ShriASM of village underASM (with seal)Certified that above particulars furnished by applicant are correct to the best of my knowledge and belief.DatePlacePublished on National Portal of India (india.gov.in) Signature of ASMName of ASM( seal)Signature of the concern Administrativeofficer of the area Administrative circle verified personally andstatement furnished by the applicant are correct to the best of my knowledge and belief.
