Declaration by Landlord in case of PAN not available

I,________________(Landlord Name) , Son / Daughter of Sh___________________hereby

by declare that I am residing at________________________________________________
(Address of Landlord) and receiving a monthly rent of INR_________________for the period
_________________

to

from

______________(Employee Name )

resident of _________________________________________________________________
(Address of employee, it would be same address which would reflect in rent receipts).

Further it is declared, that I do not have PAN / have not been allotted any PAN by the Income
Tax Authorities.

Signature (Signature of Landlord)

Date:
Place: