Sworn Affidavit

I, ___ ___, son of ___ __, holder of Indian Passport No. __ __, issued at __The Hague__ on _29th January
2021__, and presently residing at ____ ____ herby make oath/solemnly affirm and state as follows:

_______________________I am currently single & have never been married. ______________________

_____________________________________________________________________________________

_____________________________________________________________________________________

I make this solemn declaration conscientiously believing the same to be true.

No facts have been concealed.

I understand that I am liable to be prosecuted if any information contained in this affidavit is found to be
incorrect or false.

Date:

Signature: _____________________________________

Name: _____________________________________________

Signed before me at The Netherlands this ______________ day of ________________

No.______________________________

Date: ________________________

Signature & seal of Consular Officer