NON JUDICIAL STAMP PAPER OF RS.

10/-
AFFIDAVIT
I, ______________________________________________ R/o
__________________________________
____________________________________________________________________________________.
do hereby solemnly affirm and declare under oath as under: -
1. That my permanent address is_____________________________________________________
__________________________________________________________________________.
2. That I belong to ______________ (Muslim/Christian/Sikh/ Buddhist/Parsi) minority community
as notified by the Central Govt. of India.
3. That I am a citizen of India.
4. That the particulars furnished above by me are correct and that I have not concealed or
misrepresented any facts.
5. That this is my true statement.

DEPONENT

VERIFICATION: -

Verified at _____________________ on this ________________ that contents of the

above affidavit are true to the best of my knowledge and belief and nothing has been concealed
therefrom.

DEPONENT