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Declaration

Declaration by Applicant for Director Identification Number

Given by an individual applying for a DIN, verifying the correctness of the application particulars under Section 153 of the Companies Act, 2013.

DECLARATION AND VERIFICATION BY APPLICANT FOR DIRECTOR IDENTIFICATION NUMBER

Form DIR-4 (Verification) · Sections 153 & 154 read with Rule 9 of the Companies (Appointment and Qualification of Directors) Rules, 2014

I, [Applicant Name], son/daughter/wife of [Relation Name], resident of [Full Residential Address], holding PAN [PAN], do hereby declare and verify that:

  1. I have not been allotted any Director Identification Number (DIN) earlier and I have applied for only one DIN.
  2. The particulars given in the application for allotment of DIN, including my name, date of birth, address, nationality and identity/address proof, are true, correct and complete to the best of my knowledge and belief and nothing material has been concealed therefrom.
  3. I have attached self-attested copies of the documentary proof of identity and residence as required.

I understand that furnishing false or incorrect information renders me liable to penalty and action under the Companies Act, 2013.

Signature of Applicant: __________________
Name: [Applicant Name]
PAN: [PAN]
Place: [Place]
Date: [DD/MM/YYYY]

Before you use it — fill in / check

  • Applicant Name
  • Relation Name
  • Residential Address
  • PAN
  • Place & Date

How to use this template

  1. Read through and replace every [bracketed] or blank placeholder with your actual details.
  2. Delete any clause that doesn't apply and add anything specific to your situation.
  3. Click Print / Save as PDF to download, or Copy text to paste into your letterhead.
  4. Get it signed / stamped / notarised as required, and keep a copy for your records.

This is a general, editable template for convenience only — not legal advice. For anything material, have a professional review it. TaxClue isn't liable for how it's used.