JOINT DECLARATION IN THE CASE OF WHERE HUSBAND AND WIFE BOTH ARE IN SERVICE
DECLARATION BY THE HUSBAND
I __________________________ hereby declare that my wife Smt. ______________________________ is working in
_____________________ as ___________________________. I also declare that I will avail all the benefits such as Medical
Facilities, Leave Travel Concession, Children Education Assistance etc. from my office / from the office of my wife for myself and
my family members including __________________________________________________________________________________
__________________________________________________________________________________________________________
(Name & relation of the family members).
Signature :
Designation :
Emp. Code No.:
Date :
DECLARATION BY THE WIFE
I _____________________________________ hereby declare that my husband Sh. _____________________ is working in
________________________ as ________________________. I also declare that I will avail all the benefits such as Medical
Facilities, Leave Travel Concession, Children Education Assistance etc. from my office / from the office of my husband for myself
and my family members including _______________________________________________________________________________
___________________________________________________________________________________________________________
(Name & relation of the family members).
Signature :
Designation :
Emp. Code No.:
Date :
Note :
1. Acceptance of the declaration by the Competent Authority of the spouse’s office should be submitted alongwith
the declaration.
2. In case of any change in future, the same should also be intimated jointly.
