Page 144 - CURAJ Information Handbook for SC ST Cell

Annexure-II

A F F I D A V I T

(MUST BE ON Rs. 50/- STAMP PAPER)

I ___________________________________________ son/wife of ___________________________________________
(father/mother name)

resident of___________________________________________________________________________________________

do hereby make oath and state as under:-

1. That the Deponent is the father / mother of _____________________________________
(candidate name)

2. That the deponent’s daughter is a Single Girl Child/Twin Daughter/Fraternal
Daughter of the family and there is no other male and female child in my family.

Verified at _______________on this ____________________________ that the contents of the above
(place) (date - month - year)

affidavit are true and correct to my personal knowledge and belief.

DEPONENT Signature …………….....………

Name …………………..……..…….

Full Address ……………………...……………

…………………………………………………..

…………………………………………………..
Seal & Signature of …………………..……..

SDM / First Class Magistrate / Gazetted Officer (not below the rank of Tehsildar)
certifying the aforesaid declaration.

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