AFFIDAVIT OF FAMILY INCOME FOR SCHOLARSHIP OR FEE CONCESSION

I, __________, __________, resident of __________, being __________ named below, do hereby solemnly affirm and declare as under:

1. 6. That the family has no other source of income that is not stated above.

1. 7. That I understand that the scheme sets its own income limit and its own proof of income, and that this affidavit supports, and does not replace, any income certificate the scheme requires.

1. 8. That I understand that if any statement in this affidavit is found to be false, the scholarship or concession may be withdrawn, and I may be liable to action under law.

VERIFICATION

DEPONENT

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