FORMAT OF AFFIDAVIT ON Rs.

100/- STAMP PAPER

For claim of Linguistic Minority (HINDI)

IN THE COURT OF EXECUTIVE MAGISTRATE / NOTARY , __________________

(Name of city)

Deponent : ______________________________________________________________
(Name of candidates Father / Mother)
Aged about : ________ Years
Resident of _____________________________________________________________
_____________________________________________________________
_____________________________________________________________

AF F I D AV I T
I, the above named deponent do hereby take an oath and State on the Solemn affirmation
as under :-
1. THAT, the deponent is domicile of State of Maharashtra.
2. THAT, the deponents _____________, namely ______________________________
(Son / Daughter) (Full name of son / Daughter)
has passed H.S.S.C. / Intermediate examination/degree in the year _________ from
________
_______________________________________________________________.
(Name and Address of School / College)
3. THAT, the mother tongue of the candidate is HINDI and the candidate falls under
Linguistic Minority (HINDI) Category in the State of Maharashtra.
4. THAT, the deponent is executing this Affidavit to claim the Linguistic Minority
(HINDI) Category in the Maharashtra for the purpose of Admission to First/Second Year
B.E./MBA/MCA at Shri Ramdeobaba Kamla Nehru Engineering College, Nagpur AND
if this claim is found to be incorrect, I understand that the admission of candidate will be
cancelled at any later stage.
____________________ DEPONENT
(Name of City)
Date : _______________
VERIFICATION
Verified and signed at ______________ on this _____ day of _______ 20__ that the
contents of above paragraphs from 1 to 4 are true and correct to the best of my
knowledge and belief. I shall be liable to punishment u/s 199 & 200 of Indian Panel
Code, if found false or incorrect.
DEPONENT
I know the deponent DEPONENT