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AFFIDAVIT

I..........................................................................................................................................................
(FULL NAMES AND NATIONAL REGISTRATION NUMBERS)

residing at.

do hereby solemnly and sincerely swear/declare the following:-...

I make the above statement conscientiously believing the same to be true.

Signed
Signed before me at..this.day of.
DATE

MONTH

YEAR

Signed................
(COMMISSIONER OF OATHS)

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