Affidavit Form Format Affidavit form

FORMAT FOR AFFIDAVIT FORM

(To be typed on Rs. 20/- non - judicial stamp paper and to be Notarized)

To

M/s. Indian Oil Corporation Ltd.

No. 3S436 to 438, 2nd & 3rd Floor,

'Naspur House" Himayathnagar,

Hyderabad - 500 029.

Dear Sirs,

I Mr. / Mrs. ...............................................................................................

son /daughter/Wife of Mr................................................aged.......years,

residing at ................................................................................................

hereby solemnly affirm as under:

That Mr. / Mrs....................................................... who was residing
at....................................................................................................................

has left with me your equipment covered under your Subscription Voucher No............

date........ .........:.......

Since Mr.I Mrs.

does not intend making us of the said equipmeniii request that the same may be transferred to

my name and-a fresh consume$-number be given.

S.V. No..... ....date.....................issued to Mr. ............

is herewith surrendered.

I confirm that I am agreeable to submit the documents required for the same and giving you

deposit for the equipment as per your terms.

I hereby attach a letter from Mr. / Mrs.

requesting M/s. IOC / BPC / HPC to transferthe connection in my name and also authorizing you

to hand over the deposit amount to me.

I hereby undertake to indemnify M/s. IOC/BPC/HPC against any claim that

Mr./Mrs. ...............may at a laterdate make

on you in respect of either equipment or the security deposit covered under your aforesaid S.V.

for which deposit has been refunded to me by you.

Thanking you,

Yours faithfully,

SIGNATURE

NAME

Date : 

Place



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