Sample of Income Statement Certificates

1. For Self owned business / employment / freelance

Note: This declaration of income statement must be printed on a stamp paper (having value > Rs.100)
bearing the shop’s/business’ address and contact numbers .

I, (Full Name of Father/Guardian of Candidate) bearing CNIC# (Father/Guardian I.D card Number)_
hereby, truthfully state the following:
1. I am a self employed person and running the business of_________________________________
_____________________________________________________________________________________
2. The name of my business/shop is ___________________________________________________
3. The address of my business/shop is__________________________________________________
4. The business/shop location is owned by _______________________________________________
5. I deal in the following main commodities _____________________________________________
6. My total annual income from this business/shop is Rs.____________________________________
7. I have _________ number of hired workers.
I have knowingly and willfully stated the above facts for the purpose of securing need based financial Aid
and if above stated facts are found wrong at any point in time during / after my child’s academic life
cycle: financial aid, admission, degree, awards should be cancelled.
_____________________________________ _________________
Signature & Name business/Shop Owner Date
COUNTERSIGNED

Sign & Stamp: __________________ Sign & Stamp: _____________________________

(Union Councillor) (Govt. / Gazetted officer, BPS 17 or above)
Name: _________________________ Name: __________________________________
Contact No:_______________________________
2. For Farmers Only
Note: This declaration of income statement must be printed on a stamp paper (having value > Rs.100).

I, (Full Name of Father/Guardian of Candidate) bearing CNIC# (Father/Guardian I.D card Number)_
hereby, truthfully state the following:
1. I along with all my family own _(land size in acres)_ of agricultural land situated at _(complete address
of where land is situated)
2. I cultivate _(names of crop cultivated)____crops on this land.
3. My annual income from the sale of the crop is Rs._____________________________________
4. I have _________ number of hired workers working on my land.
I have knowingly and willfully stated the above facts for the purpose of securing need based financial Aid
and if above stated facts are found wrong at any point in time during / after my child’s academic life
cycle: financial aid, admission, degree, awards should be cancelled.
_____________________________________ _________________
Signature & Name Date

COUNTERSIGNED

Sign & Stamp: __________________ Sign & Stamp: _____________________________

(Union Councillor) (Govt. / Gazetted officer, BPS 17 or above)
Name: _________________________ Name: __________________________________
Contact No:_______________________________
3. For Labourers and private workers (non-salaried persons)
Note: This declaration of income statement must be printed on a stamp paper (having value > Rs.100)

I, (Father/Guardian of student _)__ bearing CNIC# (Father/Guardian I.D card Number)_ hereby,
truthfully state the following:
1. I work as a labourer/ private worker
2. My nature of work is _(Describe it e.g driver, mason, labor, security guard etc)______.
3. My monthly income from all sources is Rs.______________.
I have knowingly and willfully stated the above facts for the purpose of securing need based financial Aid
and if above stated facts are found wrong at any point in time during / after my child’s academic life
cycle: financial aid, admission, degree, awards should be cancelled.
_____________________________________ _________________
Signature & Name Date
COUNTERSIGNED

Sign & Stamp: __________________ Sign & Stamp: _____________________________

(Union Councillor) (Govt. / Gazetted officer, BPS 17 or above)
Name: _________________________ Name: __________________________________
Contact No:_______________________________

4. All salaried personnel must provide a latest salary slip duly signed by the head of
department