DECLARATION OF GIFT

I, ___________________son of Shri ________________being an Indian and Presently residing at

_________________________ do hereby solemnly declare and affirm that I have made a gift to my
_________Mr.______________, out of natural love and affection towards him, of Rs. __________(Rs.
_____________Only) on the date _________________. The said gift is made through an account payee
cheque No. _____________dated __________________ of______________Bank, _______
Branch,______________ The said gift is out of my own declared sources. Mr. _________________shall
have absolute ownership in the said gift of Rs. ________________/- and my legal heirs or I will have no
right, title or interest therein.
I have made this deed of Declaration of Gift to record the facts of the gift made by me and to avoid any
dispute in respect thereof at any future date. The above statements are true to the best of my
knowledge and belief.
Declare this Twentieth day of November, 2009 At _________ (_________) in the witness as signed
under

________________________
(Mr._________________)
The gift as stated above is accepted by me with thanks.

_____________________
(Mr._______________)