Application for Income Certificate to Gram Panchayat (Format)

Income certificate of a person is required to be submitted for availing certain benefits from the government agencies or otherwise through various scholarship schemes and subsidies.

Sometimes, the requirement would be to obtain the certificate from your local bodies viz, gram panchayat. The certificate would showcase your annual income and sources of income of your immediate family members as well.

You have to make an application to the gram panchayat to obtain the income certificate from them, which will probably be signed by the Sarpanch or any other person duly authorised for it.

Here is a template of application letter to the gram panchayat for the issue of certificate of income.

SAMPLE

To

The Sarpanch

............... Gram Panchayat

(Full Address)

Tel.: ..........................

Sub.: Application for the Issue of Certificate of Income

Dear Sir/Madam,

I am hereby submitting my application for the issue of income certificate to me. Kindly find below the required information for this purpose:

1) Applicant's Name: .......................

2) Name of the Father/ Husband: ....................

3) Age: .... years

4) Date of Birth: ...................

5) Place of Birth: ..................

6) Gender: ...............

7) Aadhar Number: ...........................

8) Mobile Number: ...........................

9) Email Id: .......................................

10) Permanent Address: 

House/ Flat Number: ........... Street: ........... Sector/Village: ............ Tehsil/ Sub-Division: ........... District: .............. State/UT: ............. Pincode: ........... Police Station: ........... Post Office: .............

11) Profession/ Occupation: ....................

12) Annual Income: ................

13) Marital status: Married/ Unmarried/ Divorced

14) Spouse's Name, Occupation & Monthly Income: .........................

15) Number of children: ........... Studying or Occupation: .................

16) Details of immovable property of yours and your spouse's: .................. Income derived from them: ...............

17) Purpose for which the Income Certificate is required: ..................

18) Did you apply for an Income Certificate before? ........... If yes, when?

I am enclosing herewith the following documents for your reference:

i) Salary slip certificate from my employer;

ii) Income-tax return of previous financial year;

iii) Form 16;

iv) Self-undertaking;

v) Identity and address proofs.

Therefore, I kindly request your goodself to issue an income certificate to me as requested hereinabove. I would be grateful to your good office if the same is provided to me at the earliest.

Thanking you,

Yours sincerely,

   (signature)

(Name of the Applicant)

Date: ..................

Place: .................

Enclosures: As Above

Self-Undertaking

I, (Name of the Applicant), aged ... years, son/daughter of (Name of the Father), presently residing at (Address) do solemnly affirm and declare that the contents of the above-mentioned application and the documents enclosed therewith are true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.

I am aware that in case the information furnished above is found to be false and incorrect, I shall be liable for prosecution under sections 177 and 191 of the Indian Penal Code, 1860, which stipulates imprisonment and fine.

   (signature)

(Name of the Applicant)

        [Photograph with cross signature

half on paper and half on photograph]

Date: ..................

Place: .................