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  • Affidavit

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    Attitudegirl Ankita
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    The document is an affidavit submitted for registration as a pharmacist. It contains 6 clauses where the deponent affirms and declares that: 1) They have been a permanent resident at the address for over [blank] years 2) They have not previously been registered in any other state pharmacy council 3) They are currently registered as a pharmacist with the [blank] State Pharmacy Council with registration number [blank] 4) If their original registration certificate is found, they will deposit it with the council's office 5) All documents submitted for registration are true and genuine 6) They will be responsible if any submitted documents are proved false and their registration may be cancelled

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    The document is an affidavit submitted for registration as a pharmacist. It contains 6 clauses where the deponent affirms and declares that: 1) They have been a permanent resident at the address for over [blank] years 2) They have not previously been registered in any other state pharmacy council 3) They are currently registered as a pharmacist with the [blank] State Pharmacy Council with registration number [blank] 4) If their original registration certificate is found, they will deposit it with the council's office 5) All documents submitted for registration are true and genuine 6) They will be responsible if any submitted documents are proved false and their registration may be cancelled

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    646 views2 pages

    Affidavit

    Uploaded by

    Attitudegirl Ankita
    The document is an affidavit submitted for registration as a pharmacist. It contains 6 clauses where the deponent affirms and declares that: 1) They have been a permanent resident at the address for over [blank] years 2) They have not previously been registered in any other state pharmacy council 3) They are currently registered as a pharmacist with the [blank] State Pharmacy Council with registration number [blank] 4) If their original registration certificate is found, they will deposit it with the council's office 5) All documents submitted for registration are true and genuine 6) They will be responsible if any submitted documents are proved false and their registration may be cancelled

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    of 2

    TO BE SUBMITTED ON A NON-JUDICIAL STAMP PAPER OF

    RS.10/- DULY ATTESTED BY 1ST CLASS MAGISTRATE

    AFFIDAVIT

    I_______________________________________S/o D/o
    ___________________
    R/o ___________________________________do hereby solemnly
    affirm and declare as under: -
    1. That I am the permanent resident of the above said address for the last
    ______years
    2. That I am not registered previously in any other state pharmacy
    council.
    3. That I am registered as pharmacist with ___________State Pharmacy
    Council bearing registration NO.________Dated___________.
    4. That I have lost my original registration certificate bearing registration
    certificate No._______Dated ____________ in case I found it, I shall
    deposit the same in the council’s office.
    5. That all the documents submitted by me for registration are true and
    genuine.
    6. That if any of the documents submitted by me for registration is to be
    proved false I shall be held responsible and my registration may be
    cancelled.

    DEPONENT

    VERIFICATION
    Verification that the contents of the affidavit are true to the best of my
    knowledge and nothing has been concealed therein.
    Today the
    ___________________Month______________Year_____________

    DEPONENT

    NOTE: - Clause 3&4 is not applicable for fresh (First) registration.

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