DECLARATION OF OWNERSHIP

(This form is required if the applicant is seeking loan on more than 25 lakh [single or
aggregate])

I, Mr/Ms_____________________________________ (Name) Son/Daughter/wife of

_________________________ residing at

(Address)_________________________________________________________________

___________

with Mobile Number____________________________ bearing the Pan Number

___________________

hereby declare that the jewellery pledged/intend to pledge at your _______ branch is the

absolute property of mine, no other person is having any rights, interest or claim over the same

and I have the absolute right to pledge the ornaments. In the event of any defect in the title to

the jewelry, I undertake to indemnify the company of all harms, cost and consequences and

also declare that I am not a Jeweller /Pawn broker (Re-pledger) in any manner whatsoever.

Signature of the customer.

Date: