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c.

GOVERNMENT SECURITIES: N.A

(PLEASE GIVE FULL DETAILS) d. e. SHARES: N.A

LIFE INSURANCE POLICIES:

60,000/-

(PLEASE FURNISH THE SURRENDER VALUE) POLICY NOS. : f. g. JEWELLERY: 2,10,000/-

INVESTMENT IN BUSUNESS IN ASSOCIATE FIRM ,IF ANY : SHARES OF POOJA

COLOUR CHEM PRIVATE LIMITED WORTH : X.A h. i. INCOME PER MONTH: 10.000/LIABILITIES: Rs. 1,40,000/-

PARTICULERS: I) II) III) BORROWINS FROM BANKS: BORROWINGS FROM MARKET: N.A 1,00.000/-

BORROWINGS FROM OTHER SOURCES:40,000/-

1, That the Statements / declaration made in this affidavit in paras 1 to 3 are true to my knowledge. Deponent is identified by Date : Deponent

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