Assam Income Certificate Application Form - Summary
Assam income certificate form is the official application format issued by the Revenue and Disaster Management Department, Government of Assam, to certify family annual income. Circle Officers issue this certificate under the Assam Right to Public Services Act for school admissions, scholarships, and state welfare benefits.
This PDF contains the printable application form in English and Assamese. It includes sections for personal identity, residential address, family member details, income sources, and the field verification report filled by the Lot Mandal.
Assam Income Certificate Form – Overview
| Detail | Information |
|---|---|
| Service name | Issuance of Income Certificate |
| Issuing department | Revenue and Disaster Management Department, Assam |
| Issuing authority | Revenue Circle Officer |
| Application mode | Online via Sewa Setu or offline at Circle Office and PFC |
| Service fee | ₹30 at Public Facilitation Centre or CSC |
| Delivery timeline | 10 working days |
| Official portal | sewasetu.assam.gov.in |
Documents Required with the Form
Submit self-attested copies of these documents with the filled form:
- Proof of identity such as Aadhaar card, voter ID card, or PAN card
- Proof of address such as electricity bill, Assam ration card, or Gaonburah certificate
- Income proof such as salary slip, bank statement, or income tax return
- Up-to-date land revenue receipt or Khazana receipt for agricultural households
- General income certificate form format if applying for central institutions outside Assam
How to fill and submit the form
STEP 1 – Print the form on clean A4 paper and write your full name, father or husband name, and contact details in capital letters.
STEP 2 – Fill your permanent and present address, including district, revenue circle, mouza, and village or town name.
STEP 3 – State your occupation along with all annual income sources, including agriculture, business, profession, or salary.
STEP 4 – Sign the self-declaration section at the bottom of the form and write the date and place.
STEP 5 – Attach self-attested copies of the required identity, residence, and income proof documents.
STEP 6 – Submit the application at the nearest Public Facilitation Centre or local Revenue Circle Office, or apply online through sewasetu.assam.gov.in.
