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Self-Declaration of Family Income and Assets
Draft for an EWS application. Copy it onto your State’s form if it has one.
I, [Applicant name], son/daughter/spouse of [Parent or spouse name], resident of [Address], [Tehsil or district], [State], declare that:
1. My caste is not in the lists of Scheduled Castes, Scheduled Tribes or Other Backward Classes of [State].
2. The total annual income of my family from all sources in financial year [Financial year] is [Income in figures] ([Income in words]).
3. My family does not own 5 acres or more of agricultural land, a residential flat of 1,000 sq ft or more, a residential plot of 100 sq yd or more in notified municipalities, or a residential plot of 200 sq yd or more outside them.
4. My family owns no other property beyond what I have declared. After adding together property in different places, I remain in the Economically Weaker Section.
5. I understand that if this declaration is false, my admission or appointment may be cancelled and I am liable under the law.
Place: [Place]
Date: [Date]
[Applicant name]
Points follow Form-II of the UP Personnel Dept OM of 14.03.2019 (ghaziabad.nic.in) and the Annexure-I asset list; checked 01.11.2026. It is not an official form. Ask your office whether a sworn affidavit on stamp paper is needed: Bihar takes an affidavit, the rules differ by State.