1.    I …………………………(Name of Landlord) S/o …………………R/o …………………….(Full address of the Landlord with pincode) do hereby declare that I have given my hosing accommodation at ……………………. (address) on rent to Mr/Ms/Mrs ……………………………………. S/o D/o ....................................... For a period of ……… months/years from …………….. (date) to ……………..(date) at a monthly rent of  Rs………… (amount) (Amount in words)

2.    Further I also declare that I do not have Income tax Permanent Account Number (PAN).

Place
Dated:                                                                                                 Name and Signature

Verification

I, the above named deponent do hereby declare that what is stated in para 1 to 2 is true to the best of my knowledge and belief and nothing has been concealed.

Place:
Dated:                                                                                                 Name and Signature