AFFIDAVIT

(Proprietor)
1. I, Akasha Zia
s/d/w of Zia Ullah , with CNIC number 3410335638001
Alam Chowk, Mohallah Nasrullah Town, Ladhywala Waraich, Tehsil and
and a permanent residence in , Distrci Gujranwala
am the proprietor of , M/S Zia Sons Medical Store
Street No.2, Hanif Wala Gala Near Muhammad Hanif Variety Store, Alam
which is situated at the Chwok,Tehsil and District Gujranwala

2.(1). Mr./Miss./Mrs. Muhammad Asim Ijaz with registration number 480-B/16 is a

qualified person with valid registration number who, to the best of my knowledge, is not employed by any
government, semi-government, or autonomous entity.
3. 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.
4. I shall abide by the provisions of the Drugs Act, 1976 and the DRAP Act, 2012, as well as any rules framed
thereunder.
5. I am not working in any government / semi-government / autonomous organization.
6. I shall personally supervise the sale of drugs.
7. I shall not sell/ stock any expired, spurious, substandard, unregistered, misbranded, counterfeit or any drugs in
violation to the drugs laws in force.
8. I shall inform the Licensing Authority for any change in supervisory staff etc.
9. I hereby solemnly affirm that:
i) I shall relieve Mr./Ms Muhammad Asim Ijaz from the services as qualified person and shall
return/handover original registration certificate to him subject to his/her one-month advance notice for
resignation from job/discontinuation of services and completion of the notice period.
ii) I shall apply the Licensing Authority for change of qualified person within the notice period.
10. 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.

Akasha Zia
(Sign and Thumb Impression)

Verfication
11. 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)