(Attested from 1st Class Magistrate)

AFFIDAVIT

I, ________(Student’s Father Name)_____________S/o _________(Grand Father Name)_____________

R/o _______________________(Full Address) ______________________________do hereby solemnly
declare as under:-

1. That I am permanently residing at said address.

2. That the name of my Son/ Daughter is _________(Student Name)____________ who is studying
_______________(Course Name & Branch Name)___________________ at _______________
(College Name)______________________
3. That I am doing _________________ and my family annual income from all sources is
Rs._______________________
4. That I have no other source of Income or income instead of that.
5. That I and my family belong to _____________ (caste name)______________ which is
_________(category name)______________
6. That none of my any family member is Government Employee.
7. That my Son/Daughter neither taken admission in any other Institute in same course nor in any
other courses.
8. That my Son/Daughter has not applied under any other Scholarship Scheme nor in any other
institute in the same Scheme.
9. That the particulars furnished above regarding my income by me are correct and I have not
concealed or misrepresented any facts for Income proof.

Deponent

Verification:-

Verified that the above affidavit is true and correct to the best of my knowledge and belief and
nothing has been concealed therein.

Dated:-

Deponent