I, A B C, of ___________, Indian Inhabitant, having address at
___________________________________ do hereby solemnly affirm, state and declare as under:-
1. I have my own funds which are my self-acquired property and/or otherwise exclusively
belongs to me. A part of the same is lying in my bank account No. ___________________
with _______________________, _______________________ Branch.
2. Out of the said funds, I record having gifted a sum of
Rs. __________/- (Rupees _____________________ only) to my son P Q R as under:-
Sr.No Date Cheque No. Drawn on Amount
1
2
3
4

Total

3. I record having gifted the above sum to my son P.Q.R. out of natural love and affection that
I bear for him.
4. Since the date of said gift, I have no direct or indirect interest in the said sum and the same
is now the absolute property of my son P. Q. R.
5. That this declaration is made by me of my own free will and accord and in a sound state of
mind to make the record of the gift absolutely clear.
6. I am assessed to Income Tax by Assessing Officer ____________________ and my
Permanent Account Number (PAN) with Income Tax Department is _______________.

Solemnly declared at __________ )
On this _______ day of _________ 200___ )

Before me;