AFFDAVIT English 1

AFFIDAVIT BY THE STUDENT
I----------------------------------------(Full name of student

with admission /registration/enrolment number ) S/O,D/O,
Mr./Mrs./Ms.----------------------------------------having been
admitted to---------------------------Name of the
Institution)------------------------have received a copy of the
UGC Regulation on curbing the Menace of Ragging in Higher
Education Institutions 2009 (here after called the Regulations)
carefully read and fully understood the provisions continued
in the said Regulations.
2) I have in particular perused clause 3 of the Regulations
and am aware as to what constituters ragging.
3) I have also in particular perused clause 7 and clause 9.1
of the Regulations and am fully aware of the penal and
administrative action that is liable to be taken against
me in case I am found guilty of or abetting activity or
passively or being part of a conspiracy to promote
ragging.
4) I here by solemnly aver and undertake that
(a) I will not indulge in any behavior or act that may
be constituted as ragging under clause 3 of the
Regulations.
(b) I will not participate in or abort or propagate
through any act of commission or omission that may
be constituted as ragging under clause 3 of the
Regulations . -----2-----
(2)
5) I here by affirm that if found guilty of ragging I am
liable for punishment according to clause 9.1 of the
Regulations without prejudice to any other criminal
action that may be taken against me under any penal law
or any law for the time being in force.
6) I here by declare that I have not been expelled or
debarred from admission in any institution in the country
on account of being found guilty of abetting or being
part of a conspiracy to promote ragging and further
affirm that in case the declaration is found to be untie
I am aware that my admission is liable to be cancelled.
Declared this-------Day-------------Month of----------Year.
Signature of deponent
Verification
Verified that the contents of this affidavit are to the best of
my knowledge and no part the affidavit is false and nothing has
been concealed or misstated therein.
Verified at (place)-------------------on this the-------Day

of--------------------month---------------Year.
Solemnly affirmed and signed in any presence on this
the-------day of-------month --------------year.
Oath commissioner
AFFIDAVIT BY PARENT/GUARDIAN
I----------------------------------------(Full name of
parent/guardian) father/mother/guardian of
--------------------------------------------------(full name of
student with admission /registration/enrolment number ) having
been admitted to---------------------------Name of the
Institution)------------------------have received
2) I have in particular perused clause 3 of the Regulations
and am aware as to what constituters ragging.
3) I have also in particular perused clause 7 and clause 9.1
of the Regulations and am fully aware of the penal and
administrative action that is liable to be taken against
me in case I am found guilty of or abetting activity or
passively or being part of a conspiracy to promote
ragging.
4) I here by solemnly aver and undertake that (a)my ward
will not indulge in any behavior or act that may be
constituted as ragging under clause 3 of the Regulations.
----2----
(2)
(b) my ward will not participate in or abort or
propagate through any act of commission or omission that
may be constituted as ragging under clause 3 of the
Regulations .
Regulations without prejudice to any other criminal
action that may be taken against me under any penal law
or any law for the time being in force.
debarred from admission in any institution in the country
on account of being found guilty of abetting or being
part of a conspiracy to promote ragging and further
affirm that in case the declaration is found to be untie
I am aware that my admission is liable to be cancelled.
Verification

of--------------------month---------------Year.
Oath commissioner
fcfYMax dk;Z djus dk vuqHko i=
Jh ftrsUnz dqekj iq= Jh jkepUnz th Mkf.k;ka
fuoklh dLck nkarkjkex<+ iqfyl Fkkus ds ihNs] rglhy
nkarkjkex<+ ftyk lhdj jkt- ds jgus okys gS bUgksus
gekjh dEiuh esa dk;Z fd;k gS] ;g ,d gkSugkj o
bZekunkj O;fDr gS] rkjh[k 17@05@2011 ls rkjh[k
03@11@2012 rd bUgksus gekjh dEiuh esa dk;Z
fd;k gSA
ge buds mTtoy Hkfo"; dh dkeuk djrs
gSA
For Nemiwal construction company
dk;Z djus dk izek.k
i=
Jh ftrsUnz dqekj iq= Jh jkepUnz th Mkf.k;ka
fuoklh xzke nkarkjkex<+ rglhy nkarkjkex<+ ftyk
lhdj jkt- okyks us gekjh QeZ esa fcfYMx dk;Z]
jksM+ odZl] ,oa Øs'kj e'khu ij lqij foftax dk dk;Z
fd;k gS] tks fnuakd 17@07@2008 ls fnuakd
15@06@2010 rd dk;Z fd;k gS] ;g ,d bZekunkj ;qod
gS] budk dk;Z ljkguh; jgk gSA

vkxs Hkxoku budh enn djsaA
Civil Works Construction Experience
Certificate
That Shree Jitendra Kumar S/o Shree Ramchandra ji
daniya from Village Danta Ramgarh Town Tehsil Danta
Ramgarh Distt Sikar (Raj) he was work in our farm from
05-08-2007 to 03-06-2008 he have good knowledge of construction of
building, water pipeline fitting, electricity fitting works, Road
works also.
We prayer to GOD for his good future.

AFFIDAVIT
I,..............................S/O..............................age
at......................Sh..............s/o..........................
residing at........................hereby on solemn affirmation state
state and declare as follows:-
1- By an application for education loan I/we applied for from the

state bank of Bikaner and Jaipur was granted by them a Term loan
of Rs............
(Rs...................).
2- I/we confirm that I/we have not availed any education loan from
any other Institution/ Bank and would not avail such loan in
future too before the repayment of the loan apply for.
3- The loan granted by SBBJ under the education purpose by us. I/we
shall submit the utilization certificate/receipt within a week's
time from the date of disbursement.
4- I/we have availed ........................loan
from ..........................and repayment is regular. We are
not defaulter of any bank.
5- We undertake that if any refund from the institution of security
(caution money and Hostel security etc.) received will
immediately be deposited in Education Loan account).
The mater and facts stated above in paragraph 1 to 5 are true to the
best of our Knowledge and belief and nothing has been concealed
there from.
Solemnly affirmed by us at.............this the ..........day
of ..............2012.
(Signature of guardian) (Signature of student)
AFFIDAVIT
I, Service No. JC 13057 Rank HONY LT. Name Late MALAM SINGH of (unit)
RAJPUT Regt, do here by affirm that if on verification of the documents the
particulars of my dependents mentioned for dependency on ECHS are found to

be false/incorrect/ forged then, I undertake to refund/make good the money
spent on the treatment of such non-entitled persons.
I shall also be liable for prosecution for forgery/misinformation and
suspension/revoking of my membership of the scheme.
Deponent
Attested by
Magistrate/Notary Public
DECLARATION
I Service No. JC 13057 Rank HONY LT. Name Late MALAM SINGH of (unit) RAJPUT
Regt solemnly affirm and declare as follows :-
1. Than I am/will be drawing pension vide PCDA pension Payment Order No
S/33438/76 Dated 18/OCT/1976.
(2) That I have the following legal department where photography is/me affixed below on
this Affidavit.
NAME Relationship DOB IDF.MARK P. II Order No
1. MALAM SINGH SELF 30.06.1931
1.
Signature photo of Dependent giving name

relation ship and Identification mark.
(photography (s) to be pasted and signed across by the Applicant).
----2----
(2)
(3) (a) That the combined monthly income (from all sources including income accruing
from house /other immovable property /fixed deposited etc.) of my dependant father
and/or mother is less than Rs.3500/-
(b)That it is here by certified that my parents (father/mother or both) do not pension
from central Govt. /State Govt./PSUS/any Private Organization and are physically
residing with me.
(4) That child /children is/are dependant on me and is /are NOT earning more than 3500/-
per month & that my daughter (s) is/are NOT married.
(5) I shall inform the ECHS imminently of his/her/their employment (earning more than
Rs-3500/-PM.
(6) That of case of any change in the status of my departments (due to death, marriage,
employment) I will inform my station I department ECHS cell at the earliest and will
stop use of ECHS facilities. I will returned in full the cost my treatment that my
dependant may have received after the she become ineligible for civil /criminal action
should I fail to do so.
(7) (a) That I am NOT a member of any medical scheme funded by central Government
PSU or any other Govt. Under taking I will impenitently inform stud HQ if I am re-
employed in the army and I am aware that my membership will remain suspended
during re-employed .
(b) That my spouse in NOT employed in Govt./public sector and is NOT a
member of CGHS or any other Govt. scheme.
(8) I understand that in case that I have submitted any incorrect or if any incorrect
information or if any ECHS member ship card is misused or used by any
unauthorized person my membership will be cancelled without notice or further
hearing In addition I will forfeit my continuation and I will pay the entire cost of
expenditure incurred on such unauthorized person I will also be liable for legal action
by the ECHS Organization I will also immediately report the loss of my ECHS
membership card to station I Headquarters.
(9) That in case on any misuse of smart Card or tampering with bills or attempt to defend
once I become a member I will forfeit my member I will forfeit my membership
automatically.
(10) I under take that in case of any misbehavior on my part with polyclinic staff my
membership may be suspended/cancelled/terminated.
(11) I am understand that the contribution I am making is one time taken amount and not
refundable even if I do not make use of any ECHS facility or opt out of ECHS
Scheme.
Signature of Deponent
----3-----
(3)
VERIFICATION
I the deponent above named do here by solemnly declare and verify that the contents of the
above affidavit are true to the best of my knowledge and belief and nothing material has been
concealed or supersede there from.
Verified at (place)------------------on this (Date)----------------day of (Month)------------year
-------------------
ATTESTATION
Certified that the above statements is declared is before me at (place)--------------------on this
-----------------day of (month)-------------------(year)----------------by DEPONENT Service No.
JC 13057 Rank HONY LT. Name Late MALAM SINGH who is identified by (Father
name of first Witness) & Name ---------------------------S/O (F-name of second Witness )
WITNESS
SIGNATURE WITNESS NO- 1 SIGNATURE WITNESS NO- 2
(Name in Block Capitals) (Name in Block Capitals
(Full Postal Address) (Full Postal Address)
--------------------------------------- ---------------------------------------------
--------------------------------------- ---------------------------------------------
--------------------------------------- --------------------------------------------
--------------------------------------- ---------------------------------------------
AFFIDAVIT
I,KAJOR MAL KHETAN alias KAJODI MAL KHETAN S/O Lat RAM BILAS
KHETAN age above 52 years
...................s/o..............at..............Sh.........
.....s/o....................residing at.............hereby on
solemn affirmation state state and declare as follows:-
1- By an application for education loan I/we applied for from

the state bank of Bikaner and Jaipur was granted by them a
Term loan of Rs............
(Rs...................).
2- I/we confirm that I/we have not availed any education loan
from any other Institution/ Bank and would not avail such
loan in future too before the repayment of the loan apply
for.
3- The loan granted by SBBJ under the education purpose by
us. I/we shall submit the utilization certificate/receipt
within a week's time from the date of disbursement.
4- I/we have availed _________________loan from
__________________and repayment is regular. We are not
defaulter of any bank.
5- We undertake that if any refund from the institution of
security (caution money and Hostel security etc.) received
will immediately be deposited in Education Loan account).
The mater and facts stated above in paragraph 1 to 5 are true
to the best of our Knowledge and belief and nothing has been
concealed there from.
Solemnly affirmed by us at.............this the _______day of
_____________2011.

AFFIDAVIT
I,...................s/o..............at..............Sh.......
.......s/o....................residing at.............hereby on
solemn affirmation state state and declare as follows:-
1- By an application for education loan I/we applied for from

the state bank of Bikaner and Jaipur was granted by them a
Term loan of Rs............
(Rs...................).
2- I/we confirm that I/we have not availed any education loan
from any other Institution/ Bank and would not avail such
loan in future too before the repayment of the loan apply
for.
3- The loan granted by SBBJ under the education purpose by
us. I/we shall submit the utilization certificate/receipt
within a week's time from the date of disbursement.
4- I/we have availed _________________loan from
__________________and repayment is regular. We are not
defaulter of any bank.
5- We undertake that if any refund from the institution of
security (caution money and Hostel security etc.) received
will immediately be deposited in Education Loan account).
The mater and facts stated above in paragraph 1 to 5 are true
to the best of our Knowledge and belief and nothing has been
concealed there from.
Solemnly affirmed by us at.............this the _______day of
_____________2011.

AFFIDAVIT FOR MINES
I--------------------------------S/o Shri---------------------
Resident of Village---------------------And solemnly affirm and
declare as under :-
1. That I am responsible for operating the mine of Granite
stone of area -----------Hect. Having Ml No.----------
N/V-------Tehsil-------------Distt-------------------in
lease name of Sh./M/S-------------------------
2. That I--------------------------s/o------------------
R/o----------------------and Prop./Part./of
M/S---------------------------------- is authorized to
sign the consent application from and other documents &
the affidavit required to be enclosed with the
application.
3. The validity of the mining lease is from---------------
to---------------------.
4. That the total capital investment in the project is
Rupees-------------------Lacs.
5. That there shall not any discharge of effulgent from the
premises of unit.
----2---
(2)
6. That all adequate measures to control water/ air pollution
has been taken care of so as to achieve the standards
prescribed under Environment (protection) Rules 1986 and
rules made there under.
7. That for the Diesel Generate Set (S) of capacity-KVA)
acoustic enclosure/acoustic treatment has been provide to
meet the prescribed norms w.r.t. Noise as per the Gazette
Notification of ministry of Environment & Forests
Government of India dated 02.01.99 adequate stack height
with D.G. Set (s) shall also be provided and maintained.
8. We have planted tress total -----------------Nos.
i.e.------------------------------.
DEPONENT
VERIFICATION
Verified-------------on this-----------------(day, month and
year), that the above contents of this affidavit are true and
correct to the best of my knowledge and belief and nothing has
been concealed there from.
DEPONENT
AFFIDAVIT
I---------------------------Son/Do Shri--------------------
Cast------------Resident of Village---------------------
Post-------------District----------------- Phone No.(With STD
Code)------------------ declare that I an admitted in Mahala
Teacher's Training collage for-------------course I solemnly
declare that :-
1. I appeared in the Pre Entrance Test ------------the photo
affixed on admission card is my own. My Pre Entrance
Test-----------Roll No.is ------------------.
2. I have not obtained less than the qualifying marks in
graduation as per rules of NCTE/UGE.
3. As per the rules laid down by the university I will be
fully responsible for minimum 75% attendance in the
course I will stay in Reengus, Sikar permanently during
the course and undergo the training.
4. I will be responsible if my attendance un the course will
not be as per the rules of the university due to Medical
leave or Maternity leaves If I am debarred by the
university from appearing in the Examination owing too
less then 75% attendance it will by my own responsibility
and I will not sue the University in the court.
5. I will strictly abide by the rules of the collage and
will be eligible for appearing the examination only after
obtained no dues certificate.
6. If my admission in cancelled by the University or the
college does not permit me to appear in the examination I
will not sue the University or the institute in the
court.
7. If I remain absent for ten (10) days regularly without
any intimation the college shall have the right to cancel
my admission.
8. Presently I am not working in any Institution/Govt.
Service or not getting any salary I will not do service
in any institution during the training period.
9. Presently I am not appearing in any exam affiliated to
any University other than this as a regular or private
student.
10. If I do not abide by the above mentioned rules the
college administration will be free to cancel my
candidature and I will not sue the Institute
administration in the court.
Date---------
Signature of the Candidate
I------------------------Son/DO Shri--------------------
Solemnly affirm that the details given in the affidavit from
papa 1 to 10 are true. I will abide by these rules.
Date------------ Signature of the Candidate

Annexure "A"
OFFICE OF THE TEHSILDAR CERTIFICATE
This is to certify that

Shri/Smt.-----------------------------S/O. or
D/O--------------------------
Resides------------------------------at--------------
His/her annual gross family income from all sources
for the year-----is Rs------------(Rs--------------)
This certificate is issued for the purpose of claiming
Interest subsidy under the scheme of the Ministry of
HRD, Government of India for pursuing approved courses
of studies in Technical & Professional streams from
recognized institutions for his son/daughter
Mr./Ms-----------------------------------------------
The signature of Shri/Smt-----------------------is
attested here below.
Signature ------------------------
Place:
Date: Signature of Tehsildar
Name:
Seal
AFFIDAVIT
I---------------------------Son/Do Shri--------------------
Cast------------Resident of Village---------------------
Post-------------District----------------- Phone No.(With STD
Code)------------------ declare that I an admitted in Mahala
Teacher's Training collage for-------------course I solemnly
declare that :-
1. I appeared in the Pre Entrance Test ------------the photo
affixed on admission card is my own. My Pre Entrance
Test-----------Roll No.is ------------------.
2. I have not obtained less than the qualifying marks in
graduation as per rules of NCTE/UGE.
3. As per the rules laid down by the university I will be
fully responsible for minimum 75% attendance in the
course I will stay in Reengus, Sikar permanently during
the course and undergo the training.
4. I will be responsible if my attendance un the course will
not be as per the rules of the university due to Medical
leave or Maternity leaves If I am debarred by the
university from appearing in the Examination owing too
less then 75% attendance it will by my own responsibility
and I will not sue the University in the court.
5. I will strictly abide by the rules of the collage and
will be eligible for appearing the examination only after
obtained no dues certificate.
6. If my admission in cancelled by the University or the
college does not permit me to appear in the examination I
will not sue the University or the institute in the
court.
7. If I remain absent for ten (10) days regularly without
any intimation the college shall have the right to cancel
my admission.
8. Presently I am not working in any Institution/Govt.
Service or not getting any salary I will not do service
in any institution during the training period.
9. Presently I am not appearing in any exam affiliated to
any University other than this as a regular or private
student.
10. If I do not abide by the above mentioned rules the
college administration will be free to cancel my
candidature and I will not sue the Institute
administration in the court.
Date---------
Signature of the Candidate
I------------------------Son/Do Shri--------------------
Solemnly affirm that the details given in the affidavit
from papa 1 to 10 are true. I will abide by these rules.
Date------------ Signature of the Candidate
DECLARATION
I SMT. SURGAIN wife of Service No. 15369403 W Rank Hav. Name Late INDRA SINGH
of (unit) C Comp. Sig. Regt solemnly affirm and declare as follows :-
1. Than I am/will be drawing pension vide PCDA pension Payment Order
No------------------ Dated -------------------.
(2) That I have the following legal department where photography is/me affixed below on
this Affidavit.
NAME Relationship DOB IDF.MARK P. II Order No
1. SURGAIN WIFE 01.07.1970
2. RAJPAL SINGH SON 19-04-1994
3. RAJVEER SINGH SON 27-06-1998
4. NAGENDRA SINGH SON 06-09-2001
1 2 3 4

relation ship and Identification mark.
----2----
(2)
from house /other immovable property /fixed deposited etc.)
residing with me.
Rs-3500/-PM.
stop use of ECHS facilities I will returned in full the cost my treatment that my
(7) (a) That I am NOT a member of any medical scheme funded by central govt PSU or
any other Govt. Under taking I will impenitently inform stud HQ if I am re-employed
in the army and I am aware that my membership will remain suspended during re-
employed .
(b) That my spouse in NOT employed in Govt./public sector and is NOT a
(8) I understand that in case that I have submitted any incorrect or if any incorrect
unauthorized person my member ship will be cancelled without notice or further
by the ECHS Organization I will also immediately report the lose of my ECHS
membership card to station I Headquarters and lodge an fir with the local civil
police .
automatically .
membership may be suspended/cancelled/terminated.
----3-----
(3)
(11) I am understand that the contribution I am making is one time taken amount and not
refundable even if I do not make use of any ECHS facility or opt out of ECHS
Scheme.
VERIFICATION
-------------------
ATTESTATION
15369403 W Rank Hav. Name Late INDRA SINGH who is identified by (Father name of
first Witness) & Name ---------------------------S/O (F-name of second Witness )
WITNESS
(Name in Block Capitals) (Name in Block Capitals
(Full Postal Address) (Full Postal Address)
--------------------------------------- ---------------------------------------------
--------------------------------------- --------------------------------------------------
---------------------------------- ---------------------------------------------
--------------------------------------- ---------------------------------------------
ATTESTED BY MAGISTRATE/NOTARY PUBLIC

AFFIDAVIT
We 1. KHEROON BEGUM ( Maiden name of wife)
2. ABDUL HAKIM TELI (Name of husband)
R/O - WARD NO. 3, MOHALA TELIYAN LOSAL
RAMGARH, SIKAR JAIPUR, RAJASTHAN do hereby
solemnly declare and affirm as under
1. That we are married under MUSLIM Marriage Act/Right
/Customs and are living together as married couple since
17.05.1994( date of marriage)
2. That KHEROON BEGUM ( Maiden name of wife) would
henceforth be known as KHEROON BEGUM (name of wife
after marriage) by virtue of our marriage.
3. That our joint photograph is affixed below
Date:- /10/2010
Signature & Address of Deponent
1.-----------------------------------------
2.-----------------------------------------
Legal Heirship Certificate
On the Strength of death Certificate bearing No. 8026/2009 and certification made by the
village Administrative Officer concerned and Mandal Revenue Inspector, this is to Certify
that the following are the legal heir(s) of the shri GOPAL LAL JAT R/O- SURERA Who died
on 07/08/2009 at SHARJAH site accident
S.no. Name Age Relation ship share of
with the
deceased
1. Bhagoti Devi 31 Wife
2. Shyam sundar 12 Son
3. Sunita 7 Daughter
4- Panni 49 Mother
The minor children mentioned to serial No.------------above
are under the care of Mr/Mrs------------------------------------
(Relationship with the minors to be mentioned) who is the
legal Guardian, and has signed on their behalf.
This certificate is issued under the prevision of Indian
Succession Act for the claiming amount of death
compensation.
Executive Magistrate/Tehsildar
AFFIDAVIT
I------------------------------------------------Director/Proprietor of
M/s---------------------------------Location-------------------------Aged--------Resident of
-----------------------P.O----------------------Distt--------------------State---------------do hereby
under taking on oath as follows:-
1- That this Consent to Establish is being obtained for manufacturing of
_________________________up to ____________________in case of any increase
in capital or addition/modification/alteration or change in process or raw
material, we will obtain fresh Consent to Establish.
2- That the plot area of the unit is ___________________Sq. Mtrs.
3- That the number of workers proposed to carry out various activities in the unit
will be workers.
4- That the total number of employees in the unit will be _____ person.
5- That the total capital investment on the project will be Rupees ______ Lacs.
6- That no trade effluent shall be generated from any of the processes.
7- That the production including the trial production shall not be undertaken until
and unless
(a) all the conditions which may be set out in grant of consent to establish are
complied with
(b) Consent to operate, both under Air (Prevention & Control of Pollution) Act-
1981 and Water (Prevention & Control of Pollution) Act- 1974 are obtained.
8- That all adequate measure to control water/ air pollution from the various
processes/ activity treatment will be taken to meet the prescribed standards as
per the Environment (Protection) Rules, 1986 as amended to date.
9- That for the Diesel Generate Set (s) (of capacity__________KVA) acoustic
enclosure/acoustic treatment will be provide to meet the prescribed norms w.r.t
noise as per the Gazette Notification of Ministry of Environment & Forests,
Government of India. Dated 02/01/99. Adequate stack height with D.G. Set(s)
shall also be provided and maintained.
10- That the cost of proposed pollution control measures has already been included
in the project report which amounts to Rs. ....................And shall only be used for
pollution control measures.
11- That the proposed industry is small/medium/large scale unit with SSI
registration No.....................................dated.........................................................
12- That all orders, direction and standards laid down by the Board, from time to
time, shall be complied with.
13- That the name and address of the Managing Director and other Directors are
given hereunder. Any change there of shall be intimated forthwith to the State
Board.
DEPONENT
VERIFICATION
Verified at----------------------on this----------------------(day, month and Year), that the
above contents of this affidavit are true and correct to the best of my Knowledge and
belief and noting has been concealed there from.
DEPONENT
AFFDAVIT
I-----------------------------------------------Cast --------------------Sub cast----------------------
Religon ------------------------- of village- --------------------------, post-
-----------------------Teh- ----------------------------------- Distt -----------------------------Rajas
than to hereby solemnly that and declare as under :-
(A) That my Father's Name is :-
(B) That my mother's name is :-
(C) That I have not been a member of any banned/political organization and has
never been in custody / Jail and no criminal of judicial case is pending against
me in any Court of law in India/abroad.
(D) That I have not been convicted for any offence under the law.
(E) That I am married/unmarried.(I got married on ------------------------------) .
Signatures_______________
Verification:-
I the above name deponent further a solemnly affirm and declare that whatsoever is
stated in this affidavit is true and correct to the best of my knowledge and believed and
nothing has been concealed therein. if the same is found incorrect i shall be liable for
disciplinary action as per the law.
With Round Seal

Place
Date:-
AFFIDAVIT
I-----------------------------S/O--------------------------------Age------Years
R/o-----------------------------do here by take oath and swear as under:
That since issue of arm licence
(1) I have not been convicted in any criminal case.
(2) There is no pending criminal prosecution in any court of law of
this country.
(3) There is no criminal case in which investigation is pending
against me.
(4) There is no case is pending against me under section 107 of cr.
pc.i e. apprehension of breach of peace from my side.
(5) The facts mentioned in item 1 to 4 above are true and correct.
DEPONENT
VERIFICATION
I, the above named deponent to here by take oath and verify and
that the consents of para no 1 to 5 of the above affidavit are beloved to
be true and correct to the best of my knowledge Nothing material has
been concealed there in and no part of it is false
Place
Date DEPONENT
AFFIDAVIT
I-----------------------------S/O--------------------------------Age------Years
R/o-----------------------------do here by take oath and swear as under:-
1- That I have been residing for the last 10 year or after attaining 18 years of age at
the addresses details of which are given below:-
(1)
(2)
2- That I have not been convicted in any criminal case.
3- That there is not case pending for criminal prosecution against me in any court of
law of this country.
4- That there in no criminal case in which investigation is pending against me.
5- That there is no case pending against me under section 107 of cr. cpc
apprehension of breach of peace from my
6- That the facts mentioned in item 1 of 5 above are true and correct
DEPONENT
VERIFICATION
I, the above named deponent to here by take oath and verify and that the
consents of para no 1 to 6 of the above affidavit are beloved to be true and correct to the
best of my knowledge Nothing material has been concealed there in and no part of it is
false
Place
Date DEPONENT
G. F. & A. R. VOL. II
GOVERNMENT OF RAJASTHAN
G. A.63 NEW FORM N0- G-A-71
GFAR 66 Rule 197
From of bond of indemnity for drawing arrears of pay &
allowance pensions of deceased Government Service or pensioners
by the claimants.
KNOW ALL MEN BY THESE PRESENTS that I---------------------
(a)-------------------------widow /husband/son/daughter of
shri/shrimati---------------------------------------------
(b)-----------------------resident at---------------------
(c)----------(here after called the "obligor" when expression
shall in lease excluded by or repugnant to the context include
her executors administrations and legal representative ) and
I/We(1)-----------------------------
S/o--------------------------resident of------------------and
(2)---------------------s/o -----------------------resident of
--------------------surety /sureties on behalf
------2-----
(2)
of the obligor hereafter the called "the surety" "sureties"
which expression shall unless exclude by or repugnant to the
context include his/their heirs executors administrators and
legal representative ) bind over less jointly and severally to
pay of the governor of rajas than (hereafter call the
Government which expression Shall unless exclude by or
repugnant to the context include his successors and assigns)an
demand and without a demur sum of
Rs................................for which payment well and
truely to be made we find ourselves firmly by these presents.
Dated this..............day of...........20........ .
WHEREAS the aforesaid Shri/ Shrimiti ................time
of his her death in the employment of receiving a pension of
Rs................from the Government.
AND WHEREAS the said Shri/ Shrimiti ................died
on the.......Day of.............20..... of and there was do to
him/her the sum of
Rs..................Rupees.................for pay and
allowances in respect of his/her said employment of receiving
in respect of his/her said pension.
AND WHEREAS the above bounded
obligor .....................claims to be entitled to the said
sum as heir of her/his/husband/wife/father. the said
Shri/Shrimati...............but has not obtained letters of
-----3-----
(3)
administration of or a succession cert ficate to the properly
any effects of Shri/Shrimati.................
(b)
AND WHEREAS the Obligor has satisfied the Government That
she he entitled to the aforesaid sum and that it would cause
undue delay and hardship if she/he were required to product
letters of administration of succession certificate to the
properly and effect of the said
Shri/Shrimati ...................... .
AND WHEREAS the Government rules and order it is necessary
that she he should first execute bond with on surely/two
sureties to indemnity again. All clams to the amount so due to
the said Shri/Shrimati ....................a the said sum can
be..............paid to the Obligor.
NOW THE CONDIRION of this bond is such that if after
payment been made to the Obligor The Obligor of the
surety/Sureties shall in the respect to the aforesaid sum of
Rs................(1)...........(Rupees...............) refund
to tje Govt. The sum of Rs.................
(Rupees................)and shall otherwise indemnity and save
Government har meese from all liability in respect of the
aforesaid sum and all cost incurred in consequence of any claim
thereto THEN the above written bond or obligation shall be void
but otherwise the said bond shall remain full force effect and
virtue.
-----4------
(4)
IN WITNESS WHERE OF the parties here to have
hereinto set their respective hands the day the year frist
above written.
......................Signed by the above named.
Signed by the above named surety/sureties in the presence
of
Witness
1..........................................
2..........................................
Accepted for and on benefit of Government Of Rajasthan
by....................in the presence of.................... .
NOTE:-
(a) Full name of the claimant (b) Name of Deceased Government
Servant/ Pensioner. (c) Full address and place of residence of
claimant.
* Signature of the Obligor.
** Signature of the First Surety.
*** Signature of the Second Surety.
@ Name and designation of the officer directed or authorized in
pursuance of Article 299(1) Of the Constitution, to accept the
bond for and on behalf of the governor
@@ Name of designation of witness
NOTE:- The obligor as well as the sureties should have attached
majority of that the bond may have legal effect or force.
New From No.

G.A 74
Rule 206-D(10),
AFFDAVIT
I-----------------------------------------------Cast --------------------Sub cast-------------------------
Religon ------------------------- of village- --------------------------, post- ------------------------
Teh- ----------------------------------- Distt -----------------------------Rajas than to hereby
solemnly that and declare as under :-
(C) That I have not been a member of any banned/political
organization and has never been in custody / Jail and no criminal
of judicial case is pending against me in any Court of law in
India/abroad.
(E) That I am married/unmarried.(I got married on ------------------------------ .
Verification:-
I the above name deponent further a solemnly affirm and declare that
whatsoever is stated in this affidavit is true and correct to the best of my knowledge and
believed and nothing has been concealed therein. if the same is found incorrect i shall be
liable for disciplinary action as per the law.
With Round Seal

Place
Date:-
I have studied & aware of the laws regarding ban
on Ragging & provisions of punishment & agrees to
abide by the punishment metted out and to his/her ward
in case the later is found guilty of ragging and/or
abetting ragging .
Signature of student Signature of

Father
AFFDAVIT
I Raju Singh S/O Narpat Singh By Cast Rajput, Religon -Hindu of
village-Khanri, Teh- Dantaramgerh-, Distt -Sikar Rajasthan to hereby
(A) That my Father's Name is :- Raju Singh
(B) That my mother's name is :- Manohar Kanwar
(C) That I have not been a member of any banned/political organization
and has never been in custody / Jail and no criminal of judicial case
is pending against me in any Court of law in India/abroad.
(E) That I am married/unmarried.(I got married
on------------------------- ) .
Verification:-
whatsoever is stated in this affidavit is true and correct to the best of my
knowledge and believed and nothing has been concealed therein. if the same
is found incorrect i shall be liable for disciplinary action as per the law.
With Round Seal

Place
Date:-
AFFIDAVIT
I, service No Jc 243366p Rank Nb/ Ris . Name GIRVIR SINGH of Unit 6
LANCER, solemnly affirm and declare as follows.-
I was enrolled in the Armored crops of Indian Army 27/12/1984 and
name and age of my Son was recorded as (name and age) Jogendra Singh
and age 17 year in my service documents It is future stated that the correct
name of my Son is name Jogendra Singh and his date of birth 04/01/1992 as
per his education ecrt I here by declare that the above individual is my one
and the same real son The age of my above named son as on
----------------------------------------(today) is working out as
---------------------------day .
The above statement is true to the best of my knowledge and belif and in
case in shames found false I shall or fake I shall be wholly responsible and
liable to be punished for the same .
(Signature of the Indl)

Army No. Jc 243366p
Rank Nb/ Ris
Name GIRVIR SINGH
Unit 6 LANCER
Date ------------------------
The above declaration given by me son is true to thw best of my knowledge
and belif in case the same is found false I am liable to be punished for the
same .
( signature of the candidate)
(1) That I am/will be drawing pension vide PCDA pension Payment Order
No------------------ Dated -------------------.
(2) That I have the following legal department where photography is/me affixed
below on this Affidavit.
Name Relationship age Date of Birth Part II Order No/CRD/SD/POR NO.
1- SANTOSH WIFE 44 15/02/1964 TRG/O8/75/81
KANWAR.
2- JITENDRA SINGH SON 20 26/12/1988 185/22/91.
3- RAJESH KANWAR DO 16 04/10/1991 114/13/93.
4- SARWAN SINGH SON 10 15/11/1997 33/113/99.
5- HARENDRA SINGH SON 8 14/10/99 140/01/2005.
1 2 3 4 5

relation ship and Identification mark. -------2-------
(2)
residing with me.
Rs-2550/-PM.
employed .
(b) That my sopouse in NOT employed in Govt./public sector and is NOT a
(8) I understand that in case that I have submitted ayn incorrect or if any incorrect
police . --------3-------
(3)
(9) I am not in possession of my service /Discharge Book (if applicable).
automatically .
membership may be suspended/cancelled by the MD ECHS.
(12) I am understand that the contribution I am making is one time taken correct is now
information even is a so not mark use as once ECHS facilities .
VERIFICATION
-------------------
ATTESTATION
JC469670 A Rank NB-SUB NAME LAXMAN SINGH who is identified by (Father name of
WITNESS
ATTESTED BY MAGISTRATE/
2) I have in particular perused clause 3 of the Regulations and
am aware as to what constituters ragging.
3) I have also in particular perused clause 7 and clause 9.1 of
the Regulations and am fully aware of the penal and
administrative action that is liable to be taken against me in
case I am found guilty of or abetting activity or passively or
being part of a conspiracy to promote ragging.
(a) I will not indulge in any behavior or act that may be
through any act of commission or omission that may be
constituted as ragging under clause 3 of the Regulations .
Regulations without prejudice to any other criminal action that
may be taken against me under any penal law or any law for the
time being in force. ----2-----
(2)

debarred from admission in any institution in the country on
account of being found guilty of abetting or being part of a
conspiracy to promote ragging and further affirm that in case
the declaration is found to be untie I am aware that my
admission is liable to be cancelled.
Verification

of--------------------month---------------Year.
Oath commissioner
I----------------------------------------(Full name of
--------------------------------------------------(full name of
(a)my ward will not indulge in any behavior or act that may
be constituted as ragging under clause 3 of the Regulations.
(b) my ward will not participate in or abort or propagate
time being in force. -----2-----
(2)


Verification

of--------------------month---------------Year.
Oath commissioner
time being in force.
Verification

of--------------------month---------------Year.
Oath commissioner
URGENT INFORMATION
COMPANY NAME- ALJABAR ALEKH
CARD NO- 88672
JCB OPERATOR NAME- RAGHUNATH RAM S/O KANARAM,
TEHSIL- DANTARAMGARH , DISTT- SIKAR
RAJASTHAN (INDIA)
THIS JCB OPERATOR WIFE ARE WILL AN ADMIT
HOSPITAL AT DANTARAMGARH DISTT- SIKAR, RAJASTHAN
. THIS IS SITATUTION IS VERY SERIOUS SO SOON SEND
INDIA THIS JCB OPERATOR RAGHUNATH RAM . CARD NO-
88672
AFFIDAVIT
I----------------------------------------S/O-------------------------------Aged-------Years
----------------------------------an Indian obabitant resident of ------------------------do
solemnly and state as follows:-
1- That I am a consumer of HP Gas for domestic use at the above address
------------------------------------My consumer No. is----------------------------I was
issued with the subscription voucher No-----------------------------Dated
-------------------------by M/S Bharat Petroleum corporation LPG
Distribution M/S----------------------------------------------towards a gas
cylinder and regular on loan for my use against the refundable deposit of
Rs--------------------------------------.
2- That was given the gas cylinder and regular when I was residing
at---------------------------thereafter I shifted to my above mentioned
residence.
3- That I am not able to produce the subscription voucher for the cylinder
and regular to obtain the refundable deposit as it is misplaced lost.
4- That I want to return the subscription voucher along with the cylinder and
regular as I am shifting my residence from this town and want to terminate
the agreement with the above maintained company.
5- That I have not assigned or transfer the subscription voucher to any
whomsoever.
6- That I undertake to return for with the above referred subscription on voucher
to Bharat if found at any time the future.
7- That I shall be liable to M./S Bharat Petroleum corporation Ltd for any loss
expense incurred by them if any one else produces the above refereed sol sorption
voucher to claim any amount from the company or their gas agent.
Solemnly affirm by the within ----------------------------------at Deponent on

this-------------------------------- Day of ----------------------2009
AFFIDAVIT
. We Choudhary Machinery store Bus stand, Reengus Road,
Danta Diatt Sikar (rajas than) swear and state as follows :
. That we have placed an order for one unit diesel driven screw
compressor"P-415 ATC" With Doosan international India Pvt.
Ltd, Pond cherry
. That we are taking delivery of the said compressor after test at
pondicherry and booking the same to our site as above through
the transport agency arranged by us.
. This compressor has been purchased for our own use and not re-
sale purpose.
. solemnly affirm on this 03 rd day Apr 2009.
For Choudhary Machinery store
(Authorized signature)
CERTIFICATE
It is certified after investigation from the records of the Sub-Registrar
Dantaramgarh Distt- Sikar and the relevant revenue and court record for last 13
years from 05 Jan 1996 to 06 Jan 2009 and from the information gathered from
sworn declaration made by date 01/12/2008 and that the Plot No- 62 measuring
86-11 sq- yards at limits of East- Bramno ki bhumi, west- Plot no- 61, North-
rasta 20 feet chora and South- Plot no- 56 .is the absolute property of Shri
LALA RAM KUMAWAT S/O SHRI HEERA LAL KUMAWAT and not a
joint family property . The said property is free from encumbrances attachments
and shri Lala Ram Kumawat has a clear and marketable title to the property .
Place- Dantaramgarh
Date- 06/01/2009.
Office seal Government Pleader /Revenue
authority
AFFIDAVIT
I Vimala Devi W/O Shri Kanhyalal Kumawat age 24 year Resident of Village Khorandi
Tehsil - Nawa District Nagaur (Rajasthan) India declare and affirms as folows:-
1- That my Husband Address- Kanhyalal S/O Shri Mohan lal Kumawat VPO-
Khorandi Teh- Nawa District Nagaur (Rajasthan) India, age 32 year is Expired
on date 26/11/2008 at Manama, Bhaharin .
2- I need my Husband's dead body .
3- So I request to MAC OF INDIA to send the dead body of my husband at my
home immediately.
Signature Vimala Devi

I, the above named deponent to here by take oath and verify and that the consents of
para no 1 to 3 of the above affidavit are beloved to be true and correct to the best of my
knowledge Nothing material has been concealed there in and no part of it is false
Date 27/11/2008
Place- Dantaramgarh Signature Vimala Devi
OFFICE OF THE -GRAM PANCHAYAT, DANSROLI,
PANCHAYAT SAMITI, DANTARAMGARH DISTT-SIKAR
RAJASTHAN(INDIA)
s. No- --------- Date------------
AGE CERTIFICATE
This is certify that Sh- SITARAM KUMAWAT S/O SH- RAMDEW
RAM KUMAWAT VILLAGE- DANSROLI, PANCHAYAT SAMITI-
DANTARAMGARH, DISTT- SIKAR RAJASTHAN(INDIA) has Date of birth
06/04/1985 at 6-15 am ( in words six April nineteen eighty five).
This is certificate issue on date on my signature and office seal.
seal Signature of the Sarpanch

POLICE CLEARANCE CERTIFICATE
This is to certify that Sh. Narendra kumar S/O Surajmal dayma Village-
Maganpura, Post- Baya, Tehsil- Dantaramgarh Distt- sikar (raj) issued by
Jaipur Date 24/09/2005.
Passport No- F 4822532
bears good moral Character reputation on the basis of the record available
in this Police Station there is no case of any kinds pending against himany
court of law at present .
Signature of Station
officer and Seal
AFFIDAVIT
I, service No Jc 469670A Rank Nb/ Sub. Name LAXMAN SINGH of Unit 14 Raj Rif,
solemnly affirm and declare as follows.-
No------------------ Dated -------------------.
KANWAR.
3- RAJESH KANWAR DO 16 04/10/1991 114/13/93.
4- SARWAN SINGH SON 10 15/11/1997 33/113/99.
1 2 3 4 5

(2)
residing with me.
Rs-2550/-PM.
employed .
police . --------3-------
(3)
automatically .
VERIFICATION
-------------------
ATTESTATION
WITNESS
NOTARY PUBLIC
Senior chief Area Manager (Indane)
Indian Oil Corporation Ltd,
Ashok Chowk, Adarsh Nagar, Jaipur.
Sir,
I here by confirm that the T.V. No. 729571 Date 25/03/2008 at NABH
GAS AGENCY Air force Station , Sector 9 GandhiNagar presented by me
to M/S Dantaramgarh Indian gas Service, Rajiv circle Bus stand
Dantaramgarh distt. sikar Rajasthan - 151595 is a genuine one if at any
time it is proved to be not genuine I authorize Indian Oil corporation Ltd.
to terminate the Indane Gas Connection given against this T.V. and also
forfeit that security deposit paid.
Consumer No. Allotted ...................

S.V. no............................................
Date of S.V......................................
Attested By Notary (Signature of Consumer)

AFFIDAVIT
I certify that Ms. SUNITA the natural Do of Shri

LAXMAN SINGH and hir Father has been continuously residing
in Rajas than for a period of 10 years and that she has studied for
at least 5 years in this period in recognized educational
institutions in Rajas than. The details of period of study in
recognized institutions are given in Performa on page2.
date-20/03/2008
Place-Dantaramgarh
Signature of the District
Magistrate/ Addl. District
Magistrate/Sub Divisional
Magistrate Executive Magistrate
AFFIDAVIT
We Hanuman Singh Age 40 year Son of Shri Amra Ram and Smt. Patasi
DeviAge 38 year W/O Shri Hanuman singh Resident of Village Bharija, Tehsil
-Dantaramgarh District Sikar (Rajasthan) India solemnly declare and affirms as
folows:-
1- That ew are the parents of Mahendra Singh Who is minor child and on
whose behalf we have made an application for his passport.
2- That we are taking care of Mahendra Singh he ia exclusively in our
physical custody.
3- We also affirm that in case of a court case arising due to issue of passport
to the minor child Mahendra Singh. We would be solely responsible for
defending the case and not the pasport Issuing Authority.
Signature
We above name deponent further a solemnly affirm and declare that whatsoever is
stated in this affidavit is true and correct to the best of my knowledge and believed
and nothing has been concealed thereiSn. if the same is found incorrect i shall be
liable for disciplinary action as per the law
date
Place Singnature and address
1- Hnnuman Singh
2- Patasi Devi
R/o Village- Bharija, Tehsil-Dantaramgarh
BANK GUARANTEE
To,
PARLE PRODUCTS PVT. LTD.
Nirlon House Worli, Mumbai-400030.
In according With the arrangement and understanding between PARLE

PRODUCTS PVT. LTD.,a company registered under the Companies Act 1956
and having its registered office at V.S. Khandekar Marg Vile,Parle(East)
Mumbai 400057 (hereinafter referred to as PARLE) and (which expression shall
unless be repugnant to the context and meaning thereof include their here,
successors, legal representative, executors and assigns) of the one part and
M/S---------------------------------------------a (Partnership/proprietor/limited
Company)and having its addressed at
-------------------------------------------------------------------------------------------------
--------------------------------(hereinafter referred to as WHOLESALER)and
(witch expression shall unless be repugnant to the context and meaning thereof,
include there heirs, successors. legal representative, executive and assigns) of
the other part have agreed furnish an unconditional bank guarantee in the name
of PARLE
-----2-----
AFFDAVIT
I. Mr. BHARON SINGH Cast. RAJPUT Sub Cast. SHEKHAWAT
Religion HINDU of Village DUDHAWA Post. DUDHAWA Teh- DANTA RAMGARH
Distt- SIKAR (Raj) to hereby solemnly that and declare as under :-
(A) That my Father's Name is :- RAGHUVEER SINGH
(B) That my mother's name is :- KRISHNA KANWAR
India/abroad.
(E) That I am married/unmarried.(I got married on UNMARRIED ) .
Verification:-
believed and nothing has been concealed thereiSn. if the same is found incorrect i shall
be liable for disciplinary action as per the law.
With Round Seal

Place
Date:-
AFFDAVIT
I. Mr. RAVINDRA KUMAR KUMAWAT Cast. KUMAWAT Sub Cast. NEMIWAL
Religion HINDU of Village PALSANA Post. PALSANA . Teh- DANTA RAMGARH
(A) That my Father's Name is :-BAJRANG LAL KUMAWAT
(B) That my mother's name is :- RUKMA DEVI
India/abroad.
Verification:-
With Round Seal

Place
Date:-
AFFIDAVIT
I S/o Age
years, R/o
do hereby take oath and swear as under :
l that I could not apply for the renewal of my arm licence within time and
the delay is for the
period.........................year.....................months....................... days.
2. that reasons for the delay in submission of application for renewal are as
under :-
3. the facts mentioned in item 1 and 2 above are true and correct.
DEPONENT
VERIFICATION
I, the above named deponent to hereby take oath and verify that the contents of para
No. 1 and 2 of the above affidavit are believed to be true and correct to the best of my
knowledge. Nothing material has been concealed therein and no part of it is false.
SO HELP ME GOG.
PLACE
DATED DEPONENT
Identified by :
AFGIS
Subroto Park,
New Delhi-110 010.
NOC TO MOROTGAGE & NON- ENCUMBRANCE CERTIFICATE

We have no objection in mortgaging Flat No.--------------------------------------------------
allotted to------------------------------------------------------------------in favour of Air Force
Group Insurance Society.
We assured you that the said building and land appurtenant thereto are not
subject to any encumbrance, charge or liability of any kind. We also assure that the
entire property is free and marketable. We have a clear, legal and marketable tittle of
the said property.
(Signature of the Authorized signatory)

(Stamp & seal of the Firm)
AFFDAVIT
I. Mr. CHOTHA MAL GOTHWAL Cast.BALAI Sub Cast.GOTHWAL
Religion HINDU of Village CHARANWAS Post. NADA Teh- DANTA RAMGARH
(A) That my Father's Name is :- SURJA RAM
(B) That my mother's name is :- MAKHI DEVI
India/abroad.
Verification:-
With Round Seal

Place
Date:-
AFFDAVIT
I. Mr. RAVINDRA KUMAR KUMAWAT Cast. KUMAWAT Sub Cast.
NEMIWAL Religion HINDU of Village PALSANA Post. PALSANA . Teh- DANTA
RAMGARH Distt- SIKAR (Raj) to hereby solemnly that and declare as under :-
India/abroad.
Verification:-
With Round Seal

Place
Date:-
AFFDAVIT
I,........................................S/O, W/O, D/O ....................................
resident of........................................hereby undertake guarantee to
safeguard the transformer provided for releasing my small
Industrial/ Non- domestic connection.
Signature of the consumer

CERTIFICATE
Dantaramgarh Distt- Sikar and the relevant revenue and court record for
last 13 years from 31 Jan 1997 to 30 Jan 2010 and from the information
gathered from sworn declaration made by date 11/12/2008 and that the Plot
No- 62 measuring 86-11 sq- yards at limits of East- Bramno ki bhumi,
west- Plot no- 61, North- rasta 20 feet chora and South- Plot no- 56 .is the
absolute property of Shri LALA RAM KUMAWAT S/O SHRI HEERA
LAL KUMAWAT and not a joint family property . The said property is
free from encumbrances attachments and shri Lala Ram Kumawat has a
clear and marketable title to the property .
Place- Dantaramgarh
Date- 09/01/2009.

authority
G. F. & A. R. VOL. II
GOVERNMENT OF RAJASTHAN
G. A.63 NEW FORM N0- G-A-71
GFAR 66 Rule 197
From of bond of indemnity for drawing arrears of pay &
allowance pensions of deceased Government Service or pensioners
by the claimants.
KNOW ALL MEN BY THESE PRESENTS That
AFFDAVIT
I-----------------------------------------------Cast --------------------Sub cast-------------------------
Religon ------------------------- of village- --------------------------, post- ------------------------
Teh- ----------------------------------- Distt -----------------------------Rajas than to hereby
India/abroad.
(E) That I am married/unmarried.(I got married on ------------------------------ .
Verification:-
believed and nothing has been concealed therein. if the same is found incorrect i shall be
liable for disciplinary action as per the law.
With Round Seal

Place
Date:-
I have studied & aware of the laws regarding ban
on Ragging & provisions of punishment & agrees to
abide by the punishment metted out and to his/her ward
in case the later is found guilty of ragging and/or
abetting ragging .
Signature of student Signature of

Father
AFFDAVIT
I Raju Singh S/O Narpat Singh By Cast Rajput, Religon -Hindu of
village-Khanri, Teh- Dantaramgerh-, Distt -Sikar Rajasthan to hereby
(A) That my Father's Name is :- Raju Singh
(B) That my mother's name is :- Manohar Kanwar
(C) That I have not been a member of any banned/political organization
and has never been in custody / Jail and no criminal of judicial case
is pending against me in any Court of law in India/abroad.
(E) That I am married/unmarried.(I got married
on------------------------- ) .
Verification:-
whatsoever is stated in this affidavit is true and correct to the best of my
knowledge and believed and nothing has been concealed therein. if the same
is found incorrect i shall be liable for disciplinary action as per the law.
With Round Seal

Place
Date:-
AFFIDAVIT
I, service No Jc 243366p Rank Nb/ Ris . Name GIRVIR SINGH of Unit 6
LANCER, solemnly affirm and declare as follows.-
I was enrolled in the Armored crops of Indian Army 27/12/1984 and
name and age of my Son was recorded as (name and age) Jogendra Singh
and age 17 year in my service documents It is future stated that the correct
name of my Son is name Jogendra Singh and his date of birth 04/01/1992 as
per his education ecrt I here by declare that the above individual is my one
and the same real son The age of my above named son as on
----------------------------------------(today) is working out as
---------------------------day .
The above statement is true to the best of my knowledge and belif and in
case in shames found false I shall or fake I shall be wholly responsible and
liable to be punished for the same .
(Signature of the Indl)

Army No. Jc 243366p
Rank Nb/ Ris
Name GIRVIR SINGH
Unit 6 LANCER
Date ------------------------
The above declaration given by me son is true to thw best of my knowledge
and belif in case the same is found false I am liable to be punished for the
same .
( signature of the candidate)
No------------------ Dated -------------------.
KANWAR.
3- RAJESH KANWAR DO 16 04/10/1991 114/13/93.
4- SARWAN SINGH SON 10 15/11/1997 33/113/99.
1 2 3 4 5

(2)
residing with me.
Rs-2550/-PM.
employed .
police . --------3-------
(3)
automatically .
VERIFICATION
-------------------
ATTESTATION
WITNESS
time being in force. ----2-----
(2)

Verification

of--------------------month---------------Year.
Oath commissioner
I----------------------------------------(Full name of
--------------------------------------------------(full name of
(a)my ward will not indulge in any behavior or act that may
be constituted as ragging under clause 3 of the Regulations.
(b) my ward will not participate in or abort or propagate
time being in force. -----2-----
(2)


Verification

of--------------------month---------------Year.
Oath commissioner
time being in force.
Verification

of--------------------month---------------Year.
Oath commissioner
URGENT INFORMATION
COMPANY NAME- ALJABAR ALEKH
CARD NO- 88672
JCB OPERATOR NAME- RAGHUNATH RAM S/O KANARAM,
TEHSIL- DANTARAMGARH , DISTT- SIKAR
RAJASTHAN (INDIA)
THIS JCB OPERATOR WIFE ARE WILL AN ADMIT
HOSPITAL AT DANTARAMGARH DISTT- SIKAR, RAJASTHAN
. THIS IS SITATUTION IS VERY SERIOUS SO SOON SEND
INDIA THIS JCB OPERATOR RAGHUNATH RAM . CARD NO-
88672
AFFIDAVIT
I----------------------------------------S/O-------------------------------Aged-------Years
----------------------------------an Indian obabitant resident of ------------------------do
solemnly and state as follows:-
1- That I am a consumer of HP Gas for domestic use at the above address
------------------------------------My consumer No. is----------------------------I was
issued with the subscription voucher No-----------------------------Dated
-------------------------by M/S Bharat Petroleum corporation LPG
Distribution M/S----------------------------------------------towards a gas
cylinder and regular on loan for my use against the refundable deposit of
Rs--------------------------------------.
2- That was given the gas cylinder and regular when I was residing
at---------------------------thereafter I shifted to my above mentioned
residence.
3- That I am not able to produce the subscription voucher for the cylinder
and regular to obtain the refundable deposit as it is misplaced lost.
4- That I want to return the subscription voucher along with the cylinder and
regular as I am shifting my residence from this town and want to terminate
the agreement with the above maintained company.
5- That I have not assigned or transfer the subscription voucher to any
whomsoever.
6- That I undertake to return for with the above referred subscription on voucher
to Bharat if found at any time the future.
7- That I shall be liable to M./S Bharat Petroleum corporation Ltd for any loss
expense incurred by them if any one else produces the above refereed sol sorption
voucher to claim any amount from the company or their gas agent.
Solemnly affirm by the within ----------------------------------at Deponent on

this-------------------------------- Day of ----------------------2009
AFFIDAVIT
. We Choudhary Machinery store Bus stand, Reengus Road,
Danta Diatt Sikar (rajas than) swear and state as follows :
. That we have placed an order for one unit diesel driven screw
compressor"P-415 ATC" With Doosan international India Pvt.
Ltd, Pond cherry
. That we are taking delivery of the said compressor after test at
pondicherry and booking the same to our site as above through
the transport agency arranged by us.
. This compressor has been purchased for our own use and not re-
sale purpose.
. solemnly affirm on this 03 rd day Apr 2009.
For Choudhary Machinery store
(Authorized signature)
CERTIFICATE
Dantaramgarh Distt- Sikar and the relevant revenue and court record for last 13
years from 31 Jan 1997 to 30 Jan 2010 and from the information gathered from
sworn declaration made by date 11/12/2008 and that the Plot No- 62 measuring
86-11 sq- yards at limits of East- Bramno ki bhumi, west- Plot no- 61, North-
rasta 20 feet chora and South- Plot no- 56 .is the absolute property of Shri
LALA RAM KUMAWAT S/O SHRI HEERA LAL KUMAWAT and not a
joint family property . The said property is free from encumbrances attachments
and shri Lala Ram Kumawat has a clear and marketable title to the property .
Place- Dantaramgarh
Date- 09/01/2009.

authority
AFFIDAVIT
I-----------------------------S/O--------------------------------Age------Years
R/o-----------------------------do here by take oath and swear as under:-
1- That I have been residing for the last 10 year or after attaining 18 years of age at
the addresses details of which are given below:-
(1)
(2)
2- That I have not been convicted in any criminal case.
3- That there is not case pending for criminal prosecution against me in any court of
law of this country.
4- That there in no criminal case in which investigation is pending against me.
5- That there is no case pending against me under section 107 of cr. cpc
apprehension of breach of peace from my
6- That the facts mentioned in item 1 of 5 above are true and correct
DEPONENT
VERIFICATION
I, the above named deponent to here by take oath and verify and that the
consents of para no 1 to 6 of the above affidavit are beloved to be true and correct to the
best of my knowledge Nothing material has been concealed there in and no part of it is
false
Place
Date DEPONENT
AFFIDAVIT
I Vimala Devi W/O Shri Kanhyalal Kumawat age 24 year Resident of Village Khorandi
Tehsil - Nawa District Nagaur (Rajasthan) India declare and affirms as folows:-
1- That my Husband Address- Kanhyalal S/O Shri Mohan lal Kumawat VPO-
Khorandi Teh- Nawa District Nagaur (Rajasthan) India, age 32 year is Expired
on date 26/11/2008 at Manama, Bhaharin .
2- I need my Husband's dead body .
3- So I request to MAC OF INDIA to send the dead body of my husband at my
home immediately.
Signature Vimala Devi

I, the above named deponent to here by take oath and verify and that the consents of
para no 1 to 3 of the above affidavit are beloved to be true and correct to the best of my
knowledge Nothing material has been concealed there in and no part of it is false
Date 27/11/2008
Place- Dantaramgarh Signature Vimala Devi
OFFICE OF THE -GRAM PANCHAYAT, DANSROLI,
PANCHAYAT SAMITI, DANTARAMGARH DISTT-SIKAR
RAJASTHAN(INDIA)
s. No- --------- Date------------
AGE CERTIFICATE
This is certify that Sh- SITARAM KUMAWAT S/O SH- RAMDEW
RAM KUMAWAT VILLAGE- DANSROLI, PANCHAYAT SAMITI-
DANTARAMGARH, DISTT- SIKAR RAJASTHAN(INDIA) has Date of birth
06/04/1985 at 6-15 am ( in words six April nineteen eighty five).
This is certificate issue on date on my signature and office seal.
seal Signature of the Sarpanch

POLICE CLEARANCE CERTIFICATE
This is to certify that Sh. Narendra kumar S/O Surajmal dayma Village-
Maganpura, Post- Baya, Tehsil- Dantaramgarh Distt- sikar (raj) issued by
Jaipur Date 24/09/2005.
Passport No- F 4822532
bears good moral Character reputation on the basis of the record available
in this Police Station there is no case of any kinds pending against himany
court of law at present .
Signature of Station
officer and Seal
AFFIDAVIT
I-----------------------------S/O--------------------------------Age------Years
R/o-----------------------------do here by take oath and swear as under:
That since issue of arm licence
(1) I have not been convicted in any criminal case.
(2) There is no pending criminal prosecution in any court of law of
this country.
(3) There is no criminal case in which investigation is pending
against me.
(4) There is no case is pending against me under section 107 of cr.
pc.i e. apprehension of breach of peace from my side.
(5) The facts mentioned in item 1 to 4 above are true and correct.
DEPONENT
VERIFICATION
I, the above named deponent to here by take oath and verify and
that the consents of para no 1 to 5 of the above affidavit are beloved to
be true and correct to the best of my knowledge Nothing material has
been concealed there in and no part of it is false
Place
Date DEPONENT
AFFIDAVIT
I, service No Jc 469670A Rank Nb/ Sub. Name LAXMAN SINGH of Unit 14 Raj Rif,
solemnly affirm and declare as follows.-
No------------------ Dated -------------------.
KANWAR.
3- RAJESH KANWAR DO 16 04/10/1991 114/13/93.
4- SARWAN SINGH SON 10 15/11/1997 33/113/99.
1 2 3 4 5

(2)
residing with me.
Rs-2550/-PM.
employed .
police . --------3-------
(3)
automatically .
VERIFICATION
-------------------
ATTESTATION
WITNESS
NOTARY PUBLIC
Senior chief Area Manager (Indane)
Indian Oil Corporation Ltd,
Ashok Chowk, Adarsh Nagar, Jaipur.
Sir,
I here by confirm that the T.V. No. 729571 Date 25/03/2008 at NABH
GAS AGENCY Air force Station , Sector 9 GandhiNagar presented by me
to M/S Dantaramgarh Indian gas Service, Rajiv circle Bus stand
Dantaramgarh distt. sikar Rajasthan - 151595 is a genuine one if at any
time it is proved to be not genuine I authorize Indian Oil corporation Ltd.
to terminate the Indane Gas Connection given against this T.V. and also
forfeit that security deposit paid.
Consumer No. Allotted ...................

S.V. no............................................
Date of S.V......................................
Attested By Notary (Signature of Consumer)

AFFIDAVIT
I certify that Ms. SUNITA the natural Do of Shri

LAXMAN SINGH and hir Father has been continuously residing
in Rajas than for a period of 10 years and that she has studied for
at least 5 years in this period in recognized educational
institutions in Rajas than. The details of period of study in
recognized institutions are given in Performa on page2.
date-20/03/2008
Place-Dantaramgarh
Signature of the District
Magistrate/ Addl. District
Magistrate/Sub Divisional
Magistrate Executive Magistrate
AFFIDAVIT
We Hanuman Singh Age 40 year Son of Shri Amra Ram and Smt. Patasi
DeviAge 38 year W/O Shri Hanuman singh Resident of Village Bharija, Tehsil
-Dantaramgarh District Sikar (Rajasthan) India solemnly declare and affirms as
folows:-
1- That ew are the parents of Mahendra Singh Who is minor child and on
whose behalf we have made an application for his passport.
2- That we are taking care of Mahendra Singh he ia exclusively in our
physical custody.
3- We also affirm that in case of a court case arising due to issue of passport
to the minor child Mahendra Singh. We would be solely responsible for
defending the case and not the pasport Issuing Authority.
Signature
We above name deponent further a solemnly affirm and declare that whatsoever is
stated in this affidavit is true and correct to the best of my knowledge and believed
and nothing has been concealed thereiSn. if the same is found incorrect i shall be
liable for disciplinary action as per the law
date
Place Singnature and address
1- Hnnuman Singh
2- Patasi Devi
R/o Village- Bharija, Tehsil-Dantaramgarh
BANK GUARANTEE
To,
PARLE PRODUCTS PVT. LTD.
Nirlon House Worli, Mumbai-400030.
In according With the arrangement and understanding between PARLE

PRODUCTS PVT. LTD.,a company registered under the Companies Act 1956
and having its registered office at V.S. Khandekar Marg Vile,Parle(East)
Mumbai 400057 (hereinafter referred to as PARLE) and (which expression shall
unless be repugnant to the context and meaning thereof include their here,
successors, legal representative, executors and assigns) of the one part and
M/S---------------------------------------------a (Partnership/proprietor/limited
Company)and having its addressed at
-------------------------------------------------------------------------------------------------
--------------------------------(hereinafter referred to as WHOLESALER)and
(witch expression shall unless be repugnant to the context and meaning thereof,
include there heirs, successors. legal representative, executive and assigns) of
the other part have agreed furnish an unconditional bank guarantee in the name
of PARLE
-----2-----
AFFDAVIT
I. Mr. BHARON SINGH Cast. RAJPUT Sub Cast. SHEKHAWAT
Religion HINDU of Village DUDHAWA Post. DUDHAWA Teh- DANTA RAMGARH
(A) That my Father's Name is :- RAGHUVEER SINGH
(B) That my mother's name is :- KRISHNA KANWAR
India/abroad.
Verification:-
With Round Seal

Place
Date:-
AFFDAVIT
I. Mr. RAVINDRA KUMAR KUMAWAT Cast. KUMAWAT Sub Cast. NEMIWAL
Religion HINDU of Village PALSANA Post. PALSANA . Teh- DANTA RAMGARH
India/abroad.
Verification:-
With Round Seal

Place
Date:-
AFFIDAVIT
I S/o Age
years, R/o
do hereby take oath and swear as under :
l that I could not apply for the renewal of my arm licence within time and
the delay is for the
period.........................year.....................months....................... days.
2. that reasons for the delay in submission of application for renewal are as
under :-
3. the facts mentioned in item 1 and 2 above are true and correct.
DEPONENT
VERIFICATION
I, the above named deponent to hereby take oath and verify that the contents of para
No. 1 and 2 of the above affidavit are believed to be true and correct to the best of my
knowledge. Nothing material has been concealed therein and no part of it is false.
SO HELP ME GOG.
PLACE
DATED DEPONENT
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AFFIDAVIT BY THE STUDENT

I----------------------------------------(Full name of student

Declared this-------Day-------------Month of----------Year.

Verified at (place)-------------------on this the-------Day

Declared this-------Day-------------Month of----------Year.

Verified at (place)-------------------on this the-------Day

Jh ftrsUnz dqekj iq= Jh jkepUnz th Mkf.k;ka

fuoklh dLck nkarkjkex<+ iqfyl Fkkus ds ihNs] rglhy

nkarkjkex<+ ftyk lhdj jkt- ds jgus okys gS bUgksus

gekjh dEiuh esa dk;Z fd;k gS] ;g ,d gkSugkj o

bZekunkj O;fDr gS] rkjh[k 17@05@2011 ls rkjh[k

03@11@2012 rd bUgksus gekjh dEiuh esa dk;Z

ge buds mTtoy Hkfo"; dh dkeuk djrs

fuoklh xzke nkarkjkex<+ rglhy nkarkjkex<+ ftyk

lhdj jkt- okyks us gekjh QeZ esa fcfYMx dk;Z]

jksM+ odZl] ,oa Øs'kj e'khu ij lqij foftax dk dk;Z

fd;k gS] tks fnuakd 17@07@2008 ls fnuakd

15@06@2010 rd dk;Z fd;k gS] ;g ,d bZekunkj ;qod

gS] budk dk;Z ljkguh; jgk gSA

That Shree Jitendra Kumar S/o Shree Ramchandra ji

daniya from Village Danta Ramgarh Town Tehsil Danta

Ramgarh Distt Sikar (Raj) he was work in our farm from

05-08-2007 to 03-06-2008 he have good knowledge of construction of

building, water pipeline fitting, electricity fitting works, Road

We prayer to GOD for his good future.

1- By an application for education loan I/we applied for from the

particulars of my dependents mentioned for dependency on ECHS are found to

Signature photo of Dependent giving name

1- By an application for education loan I/we applied for from

(Signature of guardian) (Signature of student)

1- By an application for education loan I/we applied for from

(Signature of guardian) (Signature of student)

Date------------ Signature of the Candidate

OFFICE OF THE TEHSILDAR CERTIFICATE

This is to certify that

Signature photo of Dependent giving name

ATTESTED BY MAGISTRATE/NOTARY PUBLIC

With Round Seal

New From No.

With Round Seal

Signature of student Signature of

With Round Seal

(Signature of the Indl)

Signature photo of Dependent giving name

6) I here by declare that I have not been expelled or

Verified at (place)-------------------on this the-------Day

6) I here by declare that I have not been expelled or

Declared this-------Day-------------Month of----------Year.

Verified at (place)-------------------on this the-------Day

Declared this-------Day-------------Month of----------Year.

Verified at (place)-------------------on this the-------Day

Solemnly affirm by the within ----------------------------------at Deponent on

For Choudhary Machinery store

Signature Vimala Devi

seal Signature of the Sarpanch

Signature photo of Dependent giving name

Consumer No. Allotted ...................

Attested By Notary (Signature of Consumer)