a) Format of affidavit to be submitted by the institutions applying for D.Pharm / Pharm.D./ M.Pharm/ B.Pharm (Practice) course. (On One Hundred Rupecs tudia Non Judicial Stamp Paper) Tent am the HOF (Name of the Person) (Position / Designation) of institution with complete postal address) 2. The above college has applied for following new courses to PCI from 2018-2019 academic session a) D.Pharm ( b) Pharm.D ( ©) M.Pharm ‘( 4) B.Pharm (Practice) ( Please tick (7) the relevant and cross (x) which is not applicable. 3. Thereby undertake that - 2) the institution will without fail obtain and submit consent of affiliation OF the Examining Authority for starting of the above course(s) applied for to the PCI before making aclmissions b) in case the institution fails to submit the consent of affiliation of Examining Authority for starting of the above course(s) before making admissions and comply with the prescribed norms, | understand that the approval of the PCi. if granted, shall be deemed to be withdrawn, Deponent |. the deponent above named, do hereby verify that I have read and understood the Contents of the above affidavit signed by me. I state that the facts stated in the above affidavit are true and correct to the best of my knowledge. Deponent Date :_ Place Solemnly affirmed before ne who has been identified who is known to me NOTARYb) Format of affidavit to be submitted by the course. me of the Person) (Name of institution with “complete post: The above college has applied for B.Pharm course to PCI from 2018-3019 academic session, Thereby undertake that - a) the institution will without fail obtain and submit the following documents to the PCI heliore making admissions, 2 Comment ofthe affiliation of the Examining Authority for starting of the B.Pharm course 1) NOC / approval of the State Govt. for staring of the B.Pharm course. ) that in case the institution fails to submit the above documents before making admissions and comply with the prescribed norme. | tinderstand that the approval of the PCL if granted shall be deemed to be withdrawn Deponent I the deponent above named, do herehy verily that 1 have read and understood the contents of the above affidavit si ed by me. I state that facts stated in the above affidavit are true and coreect to the best of my knowledee Deponent Date :_ Place Who has been identified by Who is known to me. NOTARY