AFFIDAVIT

I _________ son/daughter/wife of _________ resident of _________, do hereby solemnly affirm and declare as under: –

1. That I am citizen of India.
2. That my _________  died on _________.(death certificate enclosed)
3. That I have _________  gas connection on my _________  name and its connection no. _________ from _________ gas agency on the above said address.
4. That please transfer gas connection paper on my name.
5. That I have all document proofs.
6. That it is my correct statement.

Deponent

Verification:

I do hereby verify that the contents of the above said affidavit are true and correct in the best of my knowledge and belief.

Deponent