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PLEASE FILL IN DUPLICATE

SWORN AFFIDAVIT
(MISCELLANEOUS HOUSEMAID / HOUSEBOY)

I, ____________________________________________ aged _______ years residing in

__________________________________holder of Indian passport No. ______________
issued at _____________ on ______________ hereby make an oath and state as follows:

That I have no relation with Mr / Mrs / Ms ___________________________________

holder of Indian Passport No. _________________________ issued at ____________ on
____________________.
I wish to employ the person as housemaid / houseboy and I also state that I will take care
of the above mentioned person and be responsible for his / her well being during the
entire stay in UAE.
I understand that I am liable to be prosecuted, if this affidavit or any part of it is in
anyway found to be incorrect or false. I further affirm that this affidavit is true, that it
conceals nothing and no part of it is false.
Place: Dubai
Date:
Mobile:

________________________________
(Signature)

Sworn at the Consulate General of India, Dubai, this day the _________________ 2009
by Shri / Smt. ________________________ who made his / her signature before me at
Dubai. He / she has been identified by his / her passport No. _____________________
issued at _______________ on ___________________.

The Consulate General of India, Dubai take NO RESPONSILITY for the correctness
of the above statement.