AFFIDAVIT

I _________ son/daughter/wife of _________ resident of _________ do here by confirm that I/we have purchase _________ Electric Battery operated, model _________ vide VIN/Chassis no_________ from _________, _________ Dated _________
I do solemnly affirm I am a resident of _________ and have purchased the above mentioned _________  Electric Vehicle for the use in the territory of _________ only.

I was not charged the _________ amount from the Dealer and have also received the benefit of _________ % subsidy on the base price of the vehicle.

DEPONENT

Verification:-

This is verified on this date _________ at _________, that above statement is true & correct to the best of my knowledge and beliefs and nothing in concealed therein.

DEPONENT