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Schedule L (ii) Form No. 1-12

[0rmat oI lleading oI De[osilion

TWTTmGSS Forml
Cash Alo, Year 20

..........
Deposition of witness No. for the
aged about.............. taken on solemn affirmation on
the .......... ... day of ......"..... ........20
My Name .r...-.!.ri..,
son of / Daughter of.......... ..........:.....

My age is ............. ." Years I am by religion ................ . My Nationality

is ............. ......i............... and I belong to Scheduled Caste/

Schedule Tribe

My home is at Mauza ............. Police Station

District (Jharkhand) I reside at present
in Mauza ...... Police Station
Ward No. .................. District............ .......... state
Jharkhand where lam

Signature of Varified Signature of Witness

Parcrrn vilh r,antarLo
a

Schedule L (ii) Form No. 1-12

lormat oI Heailing of llG[0sition

IWitness lorml
' Gasft lVo. Year 20

aged about.............................. taken on solemn affirmation on

My Name .......:........

son of / Daughter of ..........

My age is ............. .. Years I am by religion . My Nationality

is............. and I betong to Scheduled Caste/

Schedule Tribe

Jharkhand where I am

Signature of Varified Signature of Witness

Person with remarks
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