Annexure VI

AFFIDAVIT – CUM –UNDERTAKING

( Stamped )

I ____________________________________________ aged _______________________

Son/Daughter of ____________________________________________________________

Residing at ________________________________________________________________

_________________________________________________________________ solemnly

affirm as follows :

i) I have been selected for employment in Bank of India as

___________________________________________________________
subject to receipt of satisfactory Police Verification Report.

ii) I hereby declare that I have no criminal antecedents of any kind. In case upon
verification, if there is any adverse report from the concerned authorities, my
appointment shall be liable to be terminated without any notice or pay in lieu
thereof.

iii) I also understand that if police verification report is not received within a
reasonable period not extending six months from date of the appointment letter,
Bank will be justified to cancel my appointment and terminate my services
without any notice or pay in lieu thereof.

I further declare that I may be allowed to join services in your organization subject to
what is stated above. All the facts stated above and related to employment are true and correct
to the best of my knowledge, information and belief.

Signature : ______________________________

Name : ______________________________

Roll No. : ______________________________

Place :
Date :
(Duly Notorised)