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I, __Name__ (Passport no.-____ and DOB: ____) S/o or D/o __Father Name__, Resident of
__Address__, I solemnly declare that:
Verification: I verified that the above deponent further solemnly affirm and declare that the
above statement of mine is true to the best of my Knowledge and belief and nothing has been
concealed or misstated herein.
Deponent