BEFORE THE HON.

EXECUTIVE MAGISTRATE, CHIPLUN

DATE:

The affidavit will be written to: The present Executive Magistrate of the Court

Tehsil Office: Chiplun, Dist. : Ratnagiri – 415605

Affidavit will be written by: 1) Ankush Subhash Kondvilkar, Res. at Janwale, Po.- Sringaratali,

Tal - Guhagar, Dist. Ratnagiri – 415724

2) Prajakta Sanjay Patil, Res. at - Shivaji Nagar, P.O. - Chiplun,

Tal - Chiplun, Dist. - Ratnagiri – 415605

 AFFIDAVIT
We the Sworn Name Ankush Subhash Kondwilkar, Age – 34 Years, Occupation –
Business, Res. at. Janwale, Po.- Shringartali, Ta. Guhagar, Dist. Permanent resident of Ratnagiri
– 415724 and my occupation is as mentioned above. And Prajakta Sanjay Patil, Age – 26 Years,
Occupation – Housewife, Res. at Shivaji Nagar, P.O. Chiplun, – Chiplun, Dist. – Permanent
resident of Ratnagiri – 415605 and my occupation is as mentioned above.
We state on oath that our inter-caste married names are Ankush Subhash Kondwilkar,
Age – 34 years, Profession – Business, Res. at. Janwale, Po.- Shringartali, Ta. Guhagar, Dist.
Ratnagiri and Prajakta Sanjay Patil, Age – 26 years, Occupation – Housewife, Res. at. Shivaji
Nagar, P.O. Chiplun, – Chiplun, Dist. – Ratnagiri, dated 26 January 2023 at “Patidar Bhawan”,
Chiplun, P.O. Chiplun, Tal – Chiplun, Dist. – Ratnagiri, at the marriage took place as per the
prevailing custom/manner.
We also affirm on oath that we have not been married anywhere before or we are not a
widower or a widow or a divorcee person. This is our first marriage. We have registered our
marriage for the first time at Chiplun Municipal Corporation, Chiplun in the prescribed manner
on 01/03/2023 and likewise declare on oath that our marriage has been registered for the first
time at the above mentioned place and no other office has been registered.
We state on oath that since we are inter-caste married, we have not filed any proposal
for inter-caste financial assistance scheme before.
We statement written on oath as above is true and correct. Affidavit of cause submitted
for approval.
We hereby declare on oath that all the information given above is true and correct. If it
is found to be false or incorrect, we will be guilty ourselves and Sections 191, 193(2), 200 of
the Indian Penal Code, if convicted, we shall be liable to punishment and fine accordingly.

Place :-

Date :-

Name and signature of the witness

1)

2)

Swearer / Self-

Name : Ankush Subhash Kondvilkar

Name : Prajakta Sanjay Patil