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Permanent Address Declaration

A permanent address declaration is a signed statement in which an employee confirms their permanent or native address, the proof supporting it and who lives there. Employers use it for personnel records, statutory forms and for reaching the family when the employee lives elsewhere.

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[Company Logo][Company Name]

PERMANENT ADDRESS DECLARATION

Date:: [Date]
Employee ID:: [Employee ID]

To,
The HR Department
[Company Name]
[Company Address]

Subject: Declaration of Permanent Address

I, [Employee Name], son / daughter / spouse of [Name], employed as [Designation] in the [Department] department, hereby declare that my permanent address is as follows:

House / Flat No. and Building
Street / Village
Post Office
Tehsil / Taluka
District
State and PIN Code
Nearest Police Station
Landline / Mobile Number at this Address

Residence Details

Ownership (Self-owned / Family-owned / Rented)
Name of Owner (if family-owned)
Relationship with Owner
Family Members Residing at this Address

Proof Submitted

Passport
Voter ID
Aadhaar (masked copy)
Property tax receipt / ownership document
Electricity or utility bill in the name of [Name]
Other: [Specify]

Declaration

I declare that the above address is my permanent address and that the proof submitted is genuine. I undertake to inform the HR department in writing within a reasonable time of any change in my permanent address.

Signature of Employee
[Employee Name]
Date: [Date]
Place: [Work Location]

Verified by
[HR Name]
HR Department, [Company Name]
Date: [Date]

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What this template includes

Full permanent address with district and state
Ownership status (own, family-owned, rented)
Family members residing there
Proof of address submitted
Contact number at the permanent address
Undertaking to report changes

When to use it

When the employee's permanent address differs from where they live for work
When no current-dated proof of permanent address is available
For migrant workers whose families live in another state
When statutory or BGV records need a permanent address

How to customise this template

1Add the local police station if your BGV process uses it
2Add a native-language address field for rural addresses
3Attach the specific proof you accept
4Pair with the current address declaration

HR tips

Ask for district and state, not just village name
Accept family-owned property proof with a relationship statement
Re-verify if the employee reports a move of the family
Do not reject an applicant just because they lack proof in their own name; record the alternative

Use the information only for employment and verification purposes and store it securely. Review the wording against applicable laws and your data-protection practices.

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Frequently asked questions

What is a permanent address?+

It is the address of the employee's fixed or native home, usually where the family resides, as opposed to the current address where they live for work.

What proof is accepted for permanent address?+

Common proofs are passport, voter ID, a masked Aadhaar copy, property documents or utility bills in the name of the employee or a family member.

Why is a declaration needed if proof is submitted?+

The signed declaration confirms the employee takes responsibility for the address and covers cases where proof is in a family member's name.

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[Company Logo][Company Name]
CURRENT ADDRESS DECLARATION
Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Date:
[Date]
1. Current Residential Address
Flat / Room No., Building / PG / Hostel Name
Street and Area
Landmark
City and PIN Code
Staying here since (MM/YYYY)
2. Type of Accommodation
- Rented flat / house
- Paying guest (PG)
- Hostel
- Relative's or friend's house
- Company accommodation
- Own house
3. Owner / Landlord / PG Manager Details
Form · Word
Current Address Declaration
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Flat / Room No., Building / PG / Hostel Name
Street and Area
Landmark
City and PIN Code
Staying here since (MM/YYYY)

[Company Logo][Company Name]

NOMINEE DECLARATION FORM (COMPANY DUES)

Employee Name:: [Employee Name]
Employee ID:: [Employee ID]
Designation:: [Designation]
Date of Joining:: [Date of Joining]

1. Scope of Nomination

This nomination covers amounts payable by [Company Name] in the event of my death while in service, including unpaid salary, leave encashment, pending reimbursements, performance bonus or incentive due, and any other company benefit not covered by a separate statutory nomination.

2. Nominee Details

Nominee Name	Relationship	Date of Birth	Address	Share (%)
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address]	[%]
[Nominee Name]	[Relationship]	[DD/MM/YYYY]	[Address]	[%]

3. Guardian Details (if any nominee is a minor)

Form · Word

Employee Nominee Declaration Form

Download .docx

[Company Logo][Company Name]
PAN DECLARATION FORM
Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Financial Year:
[YYYY-YY]
Section A: PAN Details
PAN
Name exactly as on PAN
Father's Name as on PAN
Date of Birth as on PAN
PAN linked with Aadhaar (Yes / No / Not sure)
Section B: If PAN Is Not Yet Available
Date of PAN Application
Acknowledgement Number
Expected Date of Receipt
Section C: Name Difference (if any)
Form · Word
PAN Declaration Form
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[Company Logo][Company Name]
AADHAAR DECLARATION AND CONSENT FORM
Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Date:
[Date]
1. Aadhaar Details
Name as on Aadhaar
Aadhaar (last 4 digits only): XXXX XXXX [Last 4 Digits]
Copy submitted (Masked copy / Not submitted)
Mobile number linked to Aadhaar (Yes / No)
2. Purpose of Collection (tick what applies)
- Linking with UAN / EPF records
- Identity verification at joining
- Other purpose: [Specify]
3. Alternate Identity Document (if Aadhaar not provided)
Form · Word
Aadhaar Declaration Form
Download .docx

PAN
Name exactly as on PAN
Father's Name as on PAN
Date of Birth as on PAN
PAN linked with Aadhaar (Yes / No / Not sure)

Date of PAN Application
Acknowledgement Number
Expected Date of Receipt

Name as on Aadhaar
Aadhaar (last 4 digits only): XXXX XXXX [Last 4 Digits]
Copy submitted (Masked copy / Not submitted)
Mobile number linked to Aadhaar (Yes / No)

[Company Logo][Company Name]

UAN DECLARATION FORM (INTERNAL)

Employee Name:: [Employee Name]
Employee ID:: [Employee ID]
Date of Joining:: [Date of Joining]
Establishment:: [Company Name]

Note: This is an internal company declaration. The official EPFO forms and online processes will also be completed where required.

A. Previous PF Membership

Were you a member of PF earlier? (Yes / No)
Do you have a UAN? (Yes / No)
UAN (if Yes)
Is the UAN activated on the member portal? (Yes / No)
Do you have more than one UAN? (Yes / No) – give details

B. Previous Employment PF History

Previous Employer	PF Member ID	Date of Joining	Date of Exit	PF Settled / Not Settled
[Employer]	[Member ID]	[DD/MM/YYYY]	[DD/MM/YYYY]	[Status]
[Employer]	[Member ID]	[DD/MM/YYYY]	[DD/MM/YYYY]	[Status]
[Employer]	[Member ID]	[DD/MM/YYYY]	[DD/MM/YYYY]	[Status]

Form · Word

UAN Declaration Form

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[Company Logo][Company Name]
ESIC DECLARATION FORM (INTERNAL)
Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Date of Joining:
[Date of Joining]
ESIC Employer Code:
[Code]
Note: This is an internal company form. Official registration will be completed by HR on the ESIC portal.
1. Eligibility
Gross monthly wages: ₹[Amount]
Covered under ESI (Yes / No – to be filled by HR)
2. Previous ESI Coverage
Were you covered under ESI earlier? (Yes / No)
Existing IP Number
Previous Employer Name and Code
Form · Word
ESIC Declaration Form
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Gross monthly wages: ₹[Amount]
Covered under ESI (Yes / No – to be filled by HR)

Were you covered under ESI earlier? (Yes / No)
Existing IP Number
Previous Employer Name and Code

[Company Logo][Company Name]

FAMILY DETAILS DECLARATION FORM

Employee Name:: [Employee Name]
Employee ID:: [Employee ID]
Department:: [Department]

1. Immediate Family

Name	Relationship	Date of Birth / Age	Occupation	City
[Name]	Father	[Age]	[Occupation]	[City]
[Name]	Mother	[Age]	[Occupation]	[City]
[Name]	Spouse	[Age]	[Occupation]	[City]
[Name]	Child	[Age]	[Occupation]	[City]
[Name]	Sibling	[Age]	[Occupation]	[City]

2. Relatives Working in [Company Name] or Group Companies

Name	Relationship	Department	Designation
[Name]	[Relationship]	[Department]	[Designation]
[Name]	[Relationship]	[Department]	[Designation]

3. Relatives Linked to Vendors, Customers or Competitors

Form · Word

Family Details Declaration Form

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[Company Logo][Company Name]

DEPENDENTS DECLARATION FORM

Employee Name:: [Employee Name]
Employee ID:: [Employee ID]
Policy Year:: [YYYY-YY]
Action:: New enrolment / Addition / Deletion

1. Benefits Covered by This Declaration

Group medical insurance
Group personal accident (family floater, if any)
Other dependant benefit: [Specify]

2. Dependant Details

Name	Relationship	Date of Birth	Gender	Financially Dependent (Yes / No)	Other Health Cover (Yes / No)
[Name]	Spouse	[DD/MM/YYYY]	[Gender]	[Yes / No]	[Yes / No]
[Name]	Child	[DD/MM/YYYY]	[Gender]	[Yes / No]	[Yes / No]
[Name]	Child	[DD/MM/YYYY]	[Gender]	[Yes / No]	[Yes / No]
[Name]	Parent / Parent-in-law	[DD/MM/YYYY]	[Gender]	[Yes / No]	[Yes / No]

3. Mid-Year Change (if applicable)

Form · Word

Dependents Declaration Form

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Permanent Address Declaration

Preview of the form

Subject: Declaration of Permanent Address

Residence Details

Proof Submitted

Declaration

What this template includes

When to use it

How to customise this template

HR tips

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Frequently asked questions

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