Annexure iV AFFIDAVIT (In case of Bachelor Martyr Awardee) The parent(s) named ___________________of No_ _______Rank_______ Name___________________ resident of village_________ PO ___________Tehsil ____________Distt _____________ and_______________________ Award of _______________ solemnly affirm and declare as under :(Name of award) 1. That my son/brother was unmarried at the time of his death. 2. That I am legal heir of my son/brother No________Rank____Name_______. 3. That I have not taken/will not take any benefit for this award from any other state in future. 4. That I am willing to accept monetary benefit for this award in lieu of land (in cases before 6.11.02) (in cases of MID award before 27.5.04) OR I am willing to accept lump sum amount in lieu of land and I shall not claim any other benefit for this award in future (in cases from 6.11.02 onwards except MID award) (in cases of MID award from 27.5.04 onwards) 5. That I understand and am conscious of the fact that this is one time lump sum award. As such I will not claim any other benefit such as land, cash award and annuity etc, under any pretext/rationale (in cases from 6.11.02 onwards except MID award) (in cases of MID award from 27.5.04 onwards). Place : Date Deponent Verification Verified at _____on this _______ day of ________ that the contents of the above affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein. Place : Date Deponent (Attested by Magistrate)
