UNDERTAKING / DECLARATION

---

---

Declarant Details

Full Name:	RAJESH KUMAR SHARMA
Father's/Husband's Name:	Shri SURESH KUMAR SHARMA
Date of Birth:	15th August, 1990
Age:	34 Years
Occupation:	Software Engineer
Nationality:	Indian

---

Address Details

Present Address

Address:	45-B, Second Floor, Rajendra Nagar
City:	New Delhi
State:	Delhi
PIN Code:	110060
Residing Since:	January 2020

Permanent Address

Address:	Village Rampur, Post Rampur
Tehsil/District:	Hapur, Ghaziabad
State:	Uttar Pradesh
PIN Code:	201001

---

Identity Documents

Document	Number
Aadhaar Number:	XXXX-XXXX-1234
PAN Number:	ABCPS1234K
Voter ID:	ABC1234567
Passport No.:	A1234567

---

Purpose of Undertaking

☑️ Name Discrepancy Declaration

---

UNDERTAKING

I, RAJESH KUMAR SHARMA, son of Shri SURESH KUMAR SHARMA, aged about 34 years, presently residing at 45-B, Second Floor, Rajendra Nagar, New Delhi - 110060, do hereby solemnly declare and undertake as follows:

---

Declaration Statement

For Name Discrepancy (Select if applicable)

I hereby declare that my name is written differently in various documents as follows:

Document	Name as Written
Aadhaar Card	RAJESH KUMAR SHARMA
PAN Card	RAJESH K SHARMA
10th Marksheet	RAJESH SHARMA
Bank Account	RAJESH KUMAR SHARMA
Passport	RAJESH KUMAR SHARMA

I hereby confirm and undertake that all the above names refer to one and the same person, i.e., myself, and my correct and complete name is RAJESH KUMAR SHARMA.

---

Alternative Undertaking Templates

Select the appropriate declaration and delete others:

---

For Date of Birth Correction

I hereby declare that my correct date of birth is 15th August, 1990 as recorded in my birth certificate / school leaving certificate.

Due to clerical error, my date of birth has been incorrectly recorded as 15th September, 1990 in my [Document Name].

I undertake to get the necessary corrections made and request the concerned authorities to accept 15th August, 1990 as my correct date of birth.

---

For Address Proof / Residential Declaration

I hereby declare that I have been residing at the following address since January 2020:

45-B, Second Floor, Rajendra Nagar, New Delhi - 110060

I undertake that this address may be treated as my current residential address for all official and legal purposes, including but not limited to:

• Bank account operations
• Aadhaar/PAN correspondence
• Voter ID registration
• Passport verification

---

For Gap Period (Education/Employment)

I hereby declare that during the period from June 2018 to December 2018, I was:

☑️ Preparing for competitive examinations (UPSC/CAT/GATE) ☐ Taking care of family responsibilities ☐ Dealing with health issues ☐ Taking a career break ☐ Other: _______________

During this period, I was neither employed nor enrolled in any educational institution. I undertake that this information is true and may be verified if required.

---

For Income Declaration

I hereby declare that my total annual income from all sources for the Financial Year 2024-25 is approximately ₹12,00,000/- (Rupees Twelve Lakh Only).

I undertake that:

• This income is derived from legitimate sources
• I have filed / will file my Income Tax Returns as per law
• I understand that false declaration may attract penalties

---

For Character & Antecedents

I hereby solemnly declare that:

1. I have never been convicted of any criminal offense by any court of law
2. I have never been arrested or detained by any law enforcement agency
3. There are no pending criminal cases against me in any court
4. I have never been dismissed from any government service
5. I have never been debarred from any examination or blacklisted by any organization

I undertake that if any of the above statements are found to be false, I shall be liable for legal action and disqualification.

---

For Lost Document

I hereby declare that my [Document Name] bearing number [Number] issued by [Authority] on [Date] has been lost/misplaced.

Details of lost document:

Document Type:	Aadhaar Card / PAN Card / Driving License
Document Number:	_______________
Date of Issue:	_______________
Issuing Authority:	_______________
Circumstances of Loss:	Lost while traveling on [Date]

I have lodged an FIR/NCR with [Police Station Name] vide FIR No. [Number] dated [Date].

I undertake that:

• I will not misuse the lost document
• If found, I will surrender it to the issuing authority
• I will not use it for any illegal purpose

---

For Single/Unmarried Status

I hereby declare that I am unmarried/single as on the date of this declaration and have never been married before.

I understand that making a false declaration regarding marital status is a punishable offense under the Indian Penal Code and other applicable laws.

---

For Non-Employment Declaration

I hereby declare that I am currently not employed with any organization, firm, or company as on the date of this declaration.

I am free to take up employment with any organization without any binding obligations from previous employment.

---

General Undertaking

I hereby undertake and confirm that:

1. All the statements made above are true, correct, and complete to the best of my knowledge and belief.

2. I have not concealed any material fact or information.

3. I understand that making a false statement or declaration is punishable under the Indian Penal Code (Section 199 - False statement in declaration).

4. I shall be solely responsible for any consequences arising from incorrect or false information.

5. This undertaking is being given voluntarily and without any coercion or undue influence.

6. I agree to provide any additional documents or clarifications if required by the concerned authorities.

---

Verification

I, the above-named declarant, do hereby verify that the contents of this undertaking are true and correct to the best of my knowledge and belief. No part of it is false and nothing material has been concealed therefrom.

Verified at New Delhi on this 1st day of January, 2025.

---

Declarant Signature

---

Witness Details (If Required)

Witness 1:

Name:
Address:
Signature:	_________________________

Witness 2:

Name:
Address:
Signature:	_________________________

---

Notary Attestation (If Required)

---

---