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Self Declaration of Not Living in Containment Area Letter format

A self declaration may be asked from any person who wants to travel to another place to declare that he was not living in the containment area recently.

self declaration of not living in containment zone format
Containment areas for Covid-19 are selected and declared by the government authorities considering the density of coronavirus infected persons in the areas.

The self declaration is taken only as a precautionary measure to bring awareness among people to not to lie about it and to avoid transfer of infection from a coronavirus infected person to others.

Here is a template of such a self declaration of not living in a containment area.



I, (Name of the Person), aged ... years, son/daughter of (Name of the Father), occupation: ..........., presently residing at (Address) in the District of ............ of State of .............., do hereby solemnly affirm and declare as under:

1. That I am not presently residing in any containment zone area as may be declared by appropriate government authority;

2. That I was not residing in any containment zone area during the last month as well;

3. That I am not suffering any fever, cough, cold, sore throat and respiratory distress or similar symptoms;

4. That I have not recently met any of my family members or any other persons who displayed aforesaid symptoms;

5. That I have not  travelled to a foreign country or to a notified area affected by Covid-19 during the last 15 days;

6. That I am not under quarantine presently as per government rules;

7. That if I develop any of the aforesaid symptoms, I shall contact the concerned health authorities, immediately;

8. That I have not been tested positive for Covid-19 disease or Coronavirus in the last two months;

9. That I undertake to adhere to health protocols, rules and regulations as may be prescribed by the Central and State governments from time to time;

10. That the information given herein above is true and correct to the best of my knowledge and belief and that nothing has been concealed therefrom.

11. That if any information is found to be false and incorrect, I will take full responsibility for its consequences and any other legal taken as may be taken in this connection.

(Name of the Person)
Mob.: ......................

Date: ................
Place: ...............