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SELF DECLARATION BY LANDLORD

I, __________________________________________ (Name of Landlord) presently


residing at____________________________________________________________
__________________________________ (Detailed Address) do hereby confirm that:

I have leased residential premises _________________________________________


_____________________________________________________ (Detailed Address)
to __________________________________________________ (Name of employee)
for the period_______________ (MMM/YYY) to _______________(MMM/YYYY)

I do not hold any Permanent account Number (PAN) issued by the tax authorities in
India.

Verification

I _________________________________________ do hereby declare and confirm


that what is stated above is correct, complete and truly stated.

Date
Place

Signature

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