AFFIDAVIT

(Qualified person)
1. I, Muqaddas Shoukat
s/d/w of Shoukat Ali , with CNIC number 3510346584962
and a permanent residence in , Chak No 66 Dinanath Tehsil Pattoki District Kasur
am the qualified person of ,
M/S Malik Medical & General Store
which is situated at the Shop#10 Opposit Ashraf Plaza Raiwind Road, Manga Mandi Lahore

2. I hereby solemnly declare that I am not currently involved in any criminal proceedings or facing any criminal
charges in any court of law. Also, I have never been convicted under rule19(1)(e) of the Punjab Drugs Rules,
2007.
3. I shall abide by the provisions of the Drugs Act, 1976 and the DRAP Act, 2012, as well as any rules framed
thereunder.
4. I am not working in any government / semi-government / autonomous organization.
5. I shall personally supervise the sale of drugs.
6. I shall not sell/ stock any expired, spurious, substandard, unregistered, misbranded, counterfeit or any drugs in
violation to the drugs laws in force.
7. I shall inform the Licensing Authority for any change in supervisory staff etc.
8. I hereby solemnly affirm that I shall tender one-month advance notice to the proprietor for resignation from
job/discontinuation of my services as a qualified person and shall continue to serve till completion of the
notice period.
9. I acknowledge that any misrepresentation about the facts of the above would result in my application being
rejected and/or my eligibility being revoked outright.

Muqaddas Shoukat
(Sign and Thumb Impression)

Verfication
10. I swear this affidavit on solemn affirmation and oath that the facts stated above are valid to the best of my
knowledge and that nothing in this affidavit is false or concealed.

(Sign and Thumb Impression)