Form 5 social security certificate requires age declaration; false declaration risks forfeiture of interest and death benefits and must be witnessed. Form 5 requires the applicant to declare their completed years of age, provide identifying relationships, sign (or give a thumb impression if illiterate), and make the statement in the presence of a witness; the form is date-stamped and signed by the Postmaster. A false declaration makes interest and death benefit in respect of certificates issued on that basis liable to forfeiture.