AFFIDAVIT

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

1.    That I have not received any kind of pension from _________  or Non- Govt. Institute and from any other state for the same.
2.    That my whole family income is _________ /- per annum.
3.    That I am citizen of _________ and residing in _________ for the at least last _________ years.
4.    That my correct date of birth /age is _________  years as my date of birth _________.
5.    That I am fully entitled to get the old age pension from the _________  Department Govt. or _________.
6.    That I am unemployed person.
7.    That is my true and correct statement.

DEPONENT

Verification: –
I, the above named deponent do hereby verify that the contents of the contents of this affidavit are true and correct to the best of my knowledge.

DEPONENT