AFFIDAVIT

Annexure to B.P.Ms.No.216, Dt:09.03.1990

(Appropriate 100/- stamp paper must be attested, by Notary or oath Commissioner)

Having considered my case for appointment in the Board under the compassionate
scheme as per the rules in A.P.S.E.Board. I, Indla Nagamani W/o.Late. Indla
Nageswararao R/o. Uppugundur Village ,N.G.Padu Mandal Prakasam District-
523186 take oath and state as follows:

That there are no earning members in my family and I am Indla Nagamani W/o. of
Late.Nageswararao
……………………………………………………………………………………………
………………………………………………………………… Division in the service of
APCPDCL was expired on ……………………………… that the family consists of
members whose details are furnished below:-
Date of
Sl. Married Relationship to the
Name Sex Birth &
No or not Board Employee
Age
That I am responsible for the maintenance of said family after the death of Late
…………………………………………………………………………………………………………

That in the event of my inability to maintain the family for any reason. I hereby

give my consent for the termination of my service in the Board without notice.

DEPONENT