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I, JAGDISH CHANDER, S/o Sh.

TIRATH DASS, resident of HOUSE NO


1142, street No-14, KAMALPUR, Teh. & Distt. Hoshiarpur the above named
deponent do hereby solemnly affirm and declare as under:-

That my wife, Smt. PAMILA PRUTHI is a government servant and is residing


at PUNE from the past twenty three years. My daughter, Ms. TANUSHREE
PRUTHI, D.O.B. 18-02-1992, is residing with my wife and studying at PUNE.

That I do not possess, and neither has applied for a Domicile Certificate of my
Daughter, Ms. TANUSHREE PRUTHI and do not intend to do so in the future.

Place: ................ Deponent

Dated: ...............

VERIFICATION
I, above named deponent do hereby solemnly affirm and declare that the
above statement of mine is true and correct to the best of my knowledge and no part
of it, is false and nothing has been concealed therein.

Dated: ................. Deponent

Place: ..................

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