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  • Affidavit: Verification

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    Anil Batra
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    The affadavit states that Bhagwan Dass, a retired middle school head in Rohtak, is submitting a medical reimbursement claim to his department. He affirms that he has not received any claim from an insurance company for the same expenses. He acknowledges that if any information provided is found to be incorrect, he will face criminal proceedings and a department inquiry, and will be solely responsible for any financial fraud related to this claim.

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    AFFIDAVI1

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    The affadavit states that Bhagwan Dass, a retired middle school head in Rohtak, is submitting a medical reimbursement claim to his department. He affirms that he has not received any claim from an insurance company for the same expenses. He acknowledges that if any information provided is found to be incorrect, he will face criminal proceedings and a department inquiry, and will be solely responsible for any financial fraud related to this claim.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    11 views1 page

    Affidavit: Verification

    Uploaded by

    Anil Batra
    The affadavit states that Bhagwan Dass, a retired middle school head in Rohtak, is submitting a medical reimbursement claim to his department. He affirms that he has not received any claim from an insurance company for the same expenses. He acknowledges that if any information provided is found to be incorrect, he will face criminal proceedings and a department inquiry, and will be solely responsible for any financial fraud related to this claim.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 1

    AFFIDAVIT

    I, Bhagwan Dass S/o Sh. Ram Ditta Mal R/o 1081/23 DLF Colony Rohtak worked as Retd Middle Head in
    School Govt. High School Chandi District Rohtak.

    I the above named deponent do hereby solemnly affirm and declare as under:-

    1. That the deponent is claiming the present medical reimbursement claim from the department.
    2. That neither the deponent has received any claim from any insurance company.
    3. That in case, any claim/information is found incorrect. I shall be ready to face criminal
    proceeding and department inquiry.
    4. That I shall be solely held responsible from any financial fraud, if committed in this regard in
    whatsoever manner.

    Deponent

    Verification:

    It is verified that the contents of Para No. 1 to 4 of the above my affidavit are to be true and
    correct to the best of my knowledge and belief and nothing relevant has kept concealed therein.

    At Rohtak Deponent

    Date

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