FAMILY INCOME CERTIFICATE
This Certificate is issued for the financial year …………………………
This is to certify that Mr./Ms. (candidate name) ……………………...…………………………………………
whose Father/Mother/Spouse is Mr./Mrs..……………………………...………………………………..,
is a resident of Village/Town …………..……………………… P.O/P.S………...………………………………..
Mouja/Taluk/Mandal ...……………...…………….……...... District………………………...……….………... State
………………….…………...……….................… and his/her family’s annual income from all sources is Rs.
……………………………………. (Rupees in words ………………………………………………………
………………………………..……………………………………..…………………….………...)
Income (Fill whichever is Profession Amount (Rs.)
applicable) (Per Annum)
a Candidate’s Income
b Father’s Income
c Mother’s Income
d Spouse Income
e Any Other Source (Siblings
or Children < 18 years age)
Gross Total Income = a+b+c+d+e Rs.
Date: ………………………………. Place: ……………………………….
(Signature with Seal)
The Family Income Certificate should be issued by the local District Authorities such as District Magistrate /
Revenue Officer / S.D.O. / B.D.O. / Mandal Revenue Officer (M.R.O.) / TAHSILDAR
__________________________________________________________________________________
Note on the definition of family income: The term family income includes the income of the candidate, the
income of his/her parents and siblings below the age of 18, also the income of his/her spouse and the children
below the age of 18 years.
Note: Income covers all sources i.e. salary, agricultural, business, profession, etc.