DE-12A

Affidavit
Affidavit son/daughter of
and presently working as .in .. Himachal
Pradesh.
I, .. son/daughter of ..
above mentioned deponent do hereby solemnly affirm and declare:
1. that I am working as in
..for the last
years . and ..months.
2. that this institution named has been
recognised/affiliated by Department of Education/H.P. Board of School
Education/C.B.S.E/ I.C.S.E vide letter number.. dated
. (the attested copy of the letter enclosed herewith).
3. I shall abide by the rules and regulations of the course & will also attend Personal
Contact Programmes (PCPs) as and when held failing which the University is at liberty
to cancel my admission.

Deponent

Verification
I, ..son/daughter of do
hereby solemnly affirm & verify that the content of the para 1 to 3 of the affidavit are true to
the best of my knowledge and belief. No part of it is false and nothing has been concealed
therefrom.

Verified at . On this Day of 2009

Deponent

Note: Affidavit on stamp paper of Rs. 3/- to be submitted at the time of the counselling duly
attested by the First Class Magistrate.