ANNEXURE "H" DECLARATION
(See clause 7(1) of G.D.D Controlled Commodities (Regulation Of Distribution Order 1966)
(i) I or any of the above mentioned member of the family do not possess ration card in my/their names nor
my name/their name/names is/are included
in the ration card elsewhere.
(ii) The above statement is complete and true to the best of my knowledge and belief and I undertake
to hold myself responsible if any part or whole
thereof is found to be false.
* Please mention H.No. given by Panchayat/Municipality or name of the Building/Flat No.
* Mention correct name and ages as per Birth Certificate.
* The declaration should be signed by the Head of the Family only.
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