Self Declaration – Affidavit

I, ________________________S/o / D/o._____________________aged _______years, with UP Nursing

Registration No. ___________, R/o. _______________________________, District _______, do hereby
submit the following information for claiming the regular employment status in
Jhunjhunwaala Institute of nursing sciences, ayodya.
1. That I’ve joined the institution on ________________ as a ___________
2. That I receive salary of Rs._________ against my position regularly in the first week
of every month.
3. That I have never shown my certificates / candidature as an employee in any
institution in and outside of Uttar Pradesh since the date of my joining in
Jhunjhunwaala institute of Nursing Sciences, Ayodhya.
I hereby declare that I have not attended any inspection against in other institution
since I joined Jhubjhunwaala Institute of Medical Sciences, Ayodhya, and further affirm
that, in case the declaration is found to be untrue, I am aware that my employees status
in liable to be cancelled.

Verified at _________  in this the _________  of _________

Deponent
Name: _________
Address: __________
Contact: _________
VERIFICATION:
Verified that the contents of this affidavit are true to the best of my knowledge and no
part of the affidavit is false and nothing has been concealed or misstated therein.

Verified at _________ in this the _________

Deponent