PROFORMA

AFFIDAVIT FOR LOSS OF ORIGINAL RECEIPT OF SD/CD

(To be furnished on Rs.20/- Stamp Paper – duly signed and Notarized)

AFFIDAVIT
We ________________________________________________________

______________Son/daughter of ______________ , aged ______________years, residing at No.

______________________________________________________________________________

hereby solemnly affrm and sincerely state as follows:

I/We declare and sincerely state that the Planning Permission obtained for the construction of
Phase-I and Phase-II of IT Park comprising 10 Blocks situated at
_____________________________________________________________________________
Taluk, ______________district and obtained PP along with CC bearing No.EC/
______________dated______________ and in Letter No. ______________dated

I/We further declare that I/We have remitted Caution/Security Deposit for Rs.
_____________ Rupees _________________________________________only) vide
Receipt No ______________dated: ___________for the IT/Spl. building to CMDA along with
STP/Security Deposits for building.

I/We assure that the said original Caution/Security Deposit receipt was misplaced and found
missing and also not traceable so far. If it finds later I/we will surrender the same without fail. And also
I/we am/are not made any claim whatsoever over the same in future.

The above informations given by me/us are true to the best of my knowlede, information and
belief.

Solemnly affirm at Chennai

On this the _____ day of _____

In the presence of the following

Witnesses: DEPONENTS

1.

BEFORE ME

2.