This is a nice alert!
Dear {{serverconnectform1.inp_a01_Surname.value}} ,
I {{inp_a01_Surname.value}} {{inp_a01_OtherNames.value}} with SSNIIT ID Number : {{inp_a01_SsnitNumber.value}} declare that every information I have provided in this form is correct to the best of my knowledge. In the event that it is detected that any information provided in this form turns out to be false, misrepresented or forged, I shall submit myself for the appropriate penalty and legal action.