PROFORMA FOR UNDERTAIKNG IN THE FORM OF AFFIDAVIT

UNDERTAKING
I, Dr. ……………………………………………………………………………………….

S/o / D/o…………………………………………………………………, bearing PG NEET / MDS

2019 Rank No ………………………….. and Hall Ticket No.………………………… give

undertaking as below, in connection with my claim under Area Status (Study

certificates/Residence certificate) and Caste Category for admission into PG Medical Degree/

Diploma and MDS Courses for the Academic Year 2019-20 in Colleges under KNR University of

Health Sciences.

I am aware that the relevant certificate (s) is / are found to be not genuine at a later date,

I forego the seat allotted in my favour. Further I agree that I abide the Rules and Regulations of

KNR University of Health Sciences and I am liable for criminal prosecution, as may be deemed

fit.

I also hereby undertake that I shall not enter into legal litigation, if the seat allotted to me

is cancelled, for the above reasons.

Signature of the Parent / Guardian Sgnature of the Candidate

Aadhar No.

Name:

Address :
Aadhar No.

Place: .

Date:
NOTE : The Bond format shall be typed on Non-Judicial Stamped paper for Rs.100/-