The document is a self declaration from a sole proprietor stating that they own a business called M/s. [blank] under their name Mr. [blank] located at [blank] with a PAN number [blank] and Service Tax number [blank].

1. SELF DECLARATION
Iam sole Proprietor for my Business in the Name
M/s. ______________________ carried under my name
Mr. ________________ having office at _________________
with Pan Number ________________
With Service Tax Number ________________
Regards