AFFIDAVIT ON NON JUDICIAL PAPER WORTH RS.5/- I _____________________________ S/O Shri____________(age, Occupation)_____________ Resident of ___________________________________ do hereby state on solemn affirmation what is stated in column 1 to 14 of application from is on the basis of my personal knowledge and belief and no false information or document has been furnished by me to get pension or benefits from the Government. If any information found to be false my pension may be stripped by the Government and recovery may be made from me of the drawn pension to which I will not offer any resistance. DEPONENT( applicant) Solemnly affirmed at__________________ This day of _____________________ 2002 And signed his name in my presence Before me. Judicial Magistrate First Class
