Specimen form of Affidavit (Indemnity Bond)
On Rs. 100/- Non judicial stamp paper duly Notarized
         To be filled by the applicant, applying for New connection/Feasibility certificate
                                          A F F I D AV I T
                                         (Indemnity Bond)
       I SVS CONSTRUCTIONS BY PATOLLA BHARATH REDDY AND OTHERS__ s/w/o.
BASWAREDDY                                             ___________________________,
aged___44______years_____BUSSINESS_____occupation___SVS
TULIP___________________________residing       at door    no.  1-65/21/SVS    TULIP
___________________________of                                            ______SIET
COLONY,MADHAPUR___________________________locality, Hyderabad/Secunderabad, do
hereby solemnly affirm and state on oath that:
   1.   I am the absolute owner of the premises of plot area __378__________Sq.Yds and
        _______4___floors and got it through Regd. Sale Deed/Gift Deed/Family partition…
        4……….
   2.   Being an absolute owner of the premises I am in need of WATER and Sewarage(New
        Connection) to which I am herewith submitting GHMC assessment number 1219973910
        and Electricity service number A9062186 for your ready reference.
   3.   I hereby undertake that there is no case pending in any of the courts regarding title of the
        premises and that I will not claim the water supply & sewerage connection sanctioned to
        me as a title deed or claim it to be an evidence in support of claiming the title over the
        premises, in case of title dispute arises, if any, in future
   4.   I hereby indemnify against the legal action against the HMWS&SB or to pay any cost or
        compensation in the vent of HMWSSB being made liable to pay in respect thereof
   5.   I also undertake to abide by the rules & regulations relating to water supply & sewerage
        in force from time to time.
   6.   I will pay the monthly bill amounts regularly without any default.
        The contents hereby declared by me are true to the best of my knowledge and in the event
of any one of the above is proved to be incorrect or false I shall be liable for departmental and
legal actions.
Deponent
Witness:
Sl. No. Name with father/husband’s name              Age      Occupation     Address     Signature
1
2
Read over the above contents and after admitting whereof the deponent signed this affidavit on
this the ______________________day of _____________________2017, in my presence.
                                                                                   NOTARY