Handicap Pension Affidavit Format

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 any kind of pension from _________ and from any other _________ from the same.
2.    That I am a citizen of _________ and residing in _________ from __ Years
3.    That my correct date of birth / age is __ years .
4.    That I was born on _________ at _________.
5.    That I am Handicap and enclosing the Handicap Certificate as a documental proof for the same, Details are below
a.    Date of Registration     :    _________
b.    Registration No.         :    _________
c.    Certificate no.         :    _________
d.    Disability Percentage     :    _________
6.    That I am unemployed.
7.    That my family annual income with all sources is _________/-.
8.    That I am fully entitled not to get the Handicap pension scheme from the _________.
9.    That this is my true statement.

DEPONENT

VERIFICATION: –

I, the above named deponent do hereby verify that the contents of this affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.

DEPONENT

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