Rs 20 STAMP PAPER

BEFORE SRI NOTARY PUBLIC, BHUABNESWAR

AFFIDAVIT

I, Mr./Miss/Mrs. Ur name, ages about 2* years, S/o- Mr. Father’s name, residing at [ur present
address], do hereby solemnly affirm and state as follows:-

1. That, I am the deponent of this affidavit.

2.

From To To Reasons for Gap

Gap Period 1 2005 2006 Preparing for
Engineering Entrance
examination.
Gap Period 2
3. That, this affidavit is required to be produced before the concerned authority of Tata
Consultancy Service(TCS) for necessary purpose.
4. That, the facts atated above are true to the best of my knowledge and belief.

Identified by,

[advocate’s signature] [your signature]

Advocate, Bhubaneswar Deponent

Sworn before me

[your signature] [notary’s seal/sign]

Deponent Notary Public, Bhubaneswar