Affidavit
Affidavit
❑Declaration of facts made in writing sworn before a person
having authority to administer an oath.
❑Deponent /Declarant must be fully described in it.
❑Affidavit to be divided in paras and numbered.
❑Facts which are true to the knowledge of deponent should
be mentioned.
Affidavit
I, Mr./Ms. -------- , s/o d/o ---------,Indian national, r/o Lake View
Colony, H. No. 267, Miramar, Goa, aged ----- do hereby solemnly
affirm and state as under :
1. I say that in my birth certificate my name is recorded as XYZ.
2. I say that in my School Leaving Certificate, my name is recorded as
XZ
3. I say that I am known by both names namely XYZ and XZ.
4. I say that XYZ and XZ are one and the same person that is myself.
5. I say that the contents of paras 1 to 4 above are true to my knowledge.
Solemnly affirmed at Panaji ,Goa on this date of _____2024.
Identified by
Date
Place sd/-
Before Me Deponent
Notary Public
Assignment
Draft an affidavit regarding loss of original HSSC marksheet in support
of an application for issue of a duplicate marksheet.
Affidavit
I, Mr./Ms. -------- , s/o d/o ---------,Indian national, r/o -------- Colony, H.
No. -----, ---------, Goa, aged ----- do hereby solemnly affirm and state as
under :
1. I say that I passed the HSSC examination in the -------stream, as a
regular candidate of _______HSS, from ____ Board in the year
----------and was placed in the Distinction/First/Second
Class/Division and my Seat No. at the said examination was ---------
for which I was issued a mark sheet by the -----------Board.
2. I say that I had gone by --------- Travels bus for an examination to
Bengaluru on ------May 2024. On my return to Goa on ----June 2024,
by ------ Travels bus bearing registration number ------,
I suddenly noticed that my folder containing my HSSC marksheet ,was
missing from my bag.
3. I say that I searched for it among my belongings but could not find it,
despite my best efforts.
4.I say that I filed a missing complaint at the Goa Police at Panaji Police
Station PI/PPS/10325/2024 dated //2024, regarding the loss of my
HSSC original marksheet.
5. I say that this affidavit is sworn in support of my application to obtain
a duplicate HSSC marksheet from the --------- Board.
6. I say that the contents of paras 1 to 5 above are true to my
knowledge.
Solemnly affirmed at Panaji ,Goa on this date of _____2024.
Identified by
Date
Place sd/-
Before Me Deponent
Notary Public
• Reference Book -
Legal Language and Legal Writing -H.K Mukherjee
