Appendix ‘C’
NON JUDICIAL STAMP PAPER
(FORMAT FOR AFFIDAVIT)
1. I, Name _______________ Son of _______________ while
applying for enrolment in Army solemnly affirm and state the following
in my respect :-
Passport size
(a) I belong to the following Caste/Religion:- photo
Caste __________ Sub Caste _________ Religion ______ 3.5 x 4.5 cm
(b) My Residential Address are as under:
(i) Permanent Home Address.
Father’s Name ___________________ House No ____ _________
Vill/Mohalla ____________________Tehsil __________________
Dist ____________________________State __________________
(ii) Postal Address.
Father’s Name ___________________ House No _____ _________
Vill/Mohalla ____________________Tehsil __________________
Dist ____________________________State __________________
(iii) I fully understand that if enrolled, a detailed verification on my
character and antecedents will be carried out by police and civil
administration from my permanent address submitted above and also
places where I have resided in the last five years.
(iv) My places of residence in the last five years are as under:-
S No From To Residential address in full i.e., House
Number, Lane/Street/Road, Village/
Town/Mohalla, Thana, Post Office,
Tehsil and District
(a)
(b)
(c)
(c) I am married / unmarried.
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(d) I hereby certify that I am not involved in any civil/criminal case.
OR
I was involved in following cases but was acquitted:-
(i) ___________________
(ii) ___________________
OR
Following court cases/ FIR are pending against me:-
(i) _______________________
(i) _______________________
(e) Consent Cert. I am below 18 Years of age and my parents give their
consent, for attending the Army Recruitment Rally. (if applicable)
Signature of Father _______________
(f) I am authorized to attend UHQ rally because I am son/ brother of No
_______________ Name ________________ Regt ______________ am eligible for
claiming bonus marks as none of my brothers have been enrolled in Army earlier / I
am not eligible to claim bonus marks (Cut whichever is not applicable).
2. I am aware that there is only one recruitment rally conducted in a recruiting year
(01 April to 31 March) for every district and therefore I am entitled to attend only once every
recruiting year from my home town district based on my nativity/ domicile certificate. I fully
understand that if I attend another recruitment rally in the same recruiting year, based on a
different district Nativity/ Domicile certificate, my candidature will be cancelled and if enrolled,
I will be dismissed from service.
3. I am attending this recruitment rally based on the Nativity/ Domicile certificate issued
by ______________(mention the state government). Details of which are as stated below:-
S/No Cert No Date of Issue Validity Issuing Authority
(a)
4. Details of nativity/ domicile certificate held by me in past (if any) are as stated below:-
S/No District Issued by Issuing Present status
date (Valid/Expired)
(a)
(b)
(c)
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5. I hereby certify that till date I have attended the following Army Recruitment Rallies:-
S/No Recruitment Army Month Category Nativity/ Domicile
Rally Venue Recruitment and applied Certificate
Office Year for Address used
(a)
(b)
(c)
6. I give an undertaking that all documents submitted by me are correct. All documents
issued by govt organisation/offices have been signed by authorized designated and
governmentt officials. If any document at any stage is found fake or wrong information is
furnished by me, I am aware that I will be dismissed from service and FIR will be lodged
against me.
Signature of Notary Signature of Candidate
