Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697804045382.pdf (India)
Self Declaration Form-‘C’ I ------------------------- S/o,D/o, W/o Sh.

----------------------------- Resident of ----------------------------------- solemnly affirm and declare that: 1.

I am unemployed and a Bonafide resident of H.P.

2.

I ------------------ passed have my examination from ------------------- Board/University/Institution recognized by H.P.

Govt.

3.

I am registered with the Employment Exchange -------------------------- Registration No.
--------- --------- from date ---------------- and my name is registered as on date.

4.

My annual family income from all sources including that of spouse is less than Rs.

2.00 Lakh ( Rs.

Two Lakhs).

5.

I am in the age group of 25-35 years.

6.

I am not getting any social/retirement/other pension from Govt.

7.

I am not a dismissed Govt.

employee.

8.

I have not been convicted of any offence resulting in imprisonment for a period of 48 hours or more.

9.
9.

I have not claimed Skill Development Allowance from any other Employment Exchange.

10.

I have read all the eligibility conditions and I fulfill the same.

The information given by me in the application for Skill Development Allowance is true.

11.

In case any eligibility criteria for receiving Skill Development Allowance (like increase in income, change in employment status, attaining age of 36 years etc.)
changes which renders me ineligible, then I shall inform the Employment Exchange and the concerned bank branch within 7 days.

I further undertake to refund the whole amount received by me with interest for any period for which I am found ineligible, as decided by the Govt.

12.
12.

I undertake to submit the self declaration in the month of March to confirm my eligibility for the Skill Development Allowance for the next Financial Year (beginning April), failing which my Allowance will be withdrawn from April of that year.

13.

I am enrolled in …………….


Course in …………….. institution in ……….. (location) which is for a period of ………….. PLACE: DATE: VERIFICATION Signature of the applicant I solemnly declare that all the facts given above are true to the best of my knowledge and belief and nothing has been concealed.

PLACE: DATE: Signature of the applicant