AFFIDAVIT OF PERSONAL PROPERTY, INCOME AND ASSETS

Name and address of Applicant

-------------------------------------------------------------------------------------------------Phone Numbers
REAL ESTATE
Address

Present fair market value Owned

A) RESIDENTIAL
Address of property
Rs xxxx lakhs

Yes

Rs xxxx lakhs

Yes

(Home, etc)
B) PLANTATION / FARM LAND

OTHER ASSETS
A) FINANCIAL ACCOUNTS
1) Current and Savings Bank Accounts: Rs xx lakhs
Account number: ____________
Branch: _____________
2) Life Insurance: Rs xxx lakhs
B) VEHICLES
Description Present fair market value Owned
1) Car type - Mid size / full size (Car make ) Rs xx lakhs Yes
C) JEWELRY, FURNITURE AND APPLIANCES
Description Present fair market value Owned
1) Gold and Diamond Jewelry Rs xx lakhs Yes
2) House Furniture and Appliances Rs xx lakhs Yes

INCOME FROM ALL SOURCES (Per month)

A) Net Business Income Rs xx lakhs per month
B) Net income from Salary Rs xx lakhs per month
OATH OF AFFIANT
I, Applicant Name hereby swear or affirm that the information set forth in this Affidavit of
Personal Property, Income and Assets above is true, complete, and accurate.

_______________________
Signature of AFFIANT (Applicant)
Sworn to and subscribed before me this __________ Day of __________________,
____________.

____________________
Notary Public