AFFIDAVIT ON STAMP PAPER WORTH Rs.

10/-

FORMAT
lR;kfir
“kiFk&i= QksVks

le{k% Jheku lektdY;k.k vf/kdkjh xkft;kckn

“kiFk i= vksj ls --------------------------------------------------iq=--------------

-------------------------------------------fuoklh------------------------------------
---------“kiFk iwoZd dFku djrk gw¡ fd%&
1- ;g fd esjk mijksDr uke o irk lgh gSA
2- ;g fd eS----------------------------------------------vkbZ-Vh-,l- eksgu
uxj esa l= 2018&19 esa ¼dkslZ½------------------------------------
---------dk Nk= gw¡
3- ;g fd esjh tUe frfFk-------------------------------------------gSA
4- ;g fd esjh tkfr-----------------------------------------tks ------------------
--------------------------oxZ ds vUrxZr vkrh gSA
5- ;g fd esjs firk dh ekfld vk;---------------------------------------------
rFkk okf’kZd vk;----------------------------------tks fd esjs }kjk tek
fd;s x;s izek.k i= la[;k--------------------------------ij vafdr gSA
6- ;g fd esjs firkth ds vk; dk lzks= dsoy -----------------------------
gS] tks fd eSus vius izos”k ds le; vkosnu QkeZ es fn;k gSA
7- ;g fd esjs firkth }kjk vk; izek.k i= esa nh x;h tkudkjh iw.kZrk
lgh gSA
8- ;g fd l= 2018&19 esa eSus fdlh vU; foHkkx @laLFkk ls fdlh
Hkh izdkj ls dksbZ Nk=o`fr ugh izkIr dh gS vkSj lekt dY;k.k
foHkkx }kjk Nk=o`fr izkIr djus ds ckn fdlh vU; foHkkx
@laLFkk ls fdlh Hkh izkdkj dh Nk=o`fr ugh d:¡xk@d:¡xhA
9- ;g fd fdlh Hkh izdkj dh tk¡p esa ;fn esjk vk; izek.k i= vFkok tkfr
izek.k i= vFkok nksuks xyr ik;s tkrs gS rks mlds fy, eS
iw.kZr;k mRrjnk;h gw¡xk vkSj lekt dY;k.k foHkkx }kjk
Nk=o`fr@“kqYd izfriwfrZ ds :i esa tkjh fd x;h /kujk”kh 18%
C;kt lfgr foHkkx dks okil dj nwxk¡@nwxh ,ao foHkkx esjs
f[kykQ leqfpr fof/kd dk;Zokgh ds fy;s sLora= gksxkA

LFkku% “kiFkdrkZ
fnukad%
uke%--------------------------------------------------------------------------------
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firk dk uke%-----------------------------------------------------------------------
--
irk%---------------------------------------------------------------------------------
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eksckbZy u0%-¼Nk=½--------------------------------------------------------
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