AFFIDAVIT BY THE STUDENT
I,___________________________________________(full name of student with Application Number) s/o d/o Mr./Mrs. ________________________, having been admitted to Manav Rachna International University, Faridabad ___________________________________________________(name of the course) have read and understood the contents of the Brochure including the policy regarding Group Insurance mentioned on Page No. 94 of the Brochure of Manav Rachna International University Faridabad. That in view of clause (e) mentioned under the heading “List of Other Documents to Be Deposited after the Admission” on Page No. 94 of the Brochure; AND Further in view of clause 3 mentioned on Page No. 94 of the Brochure which states that “Protection of fee payable upto Rs 4 Lacs for the remaining duration of the course in case of accidental death of the earning parent of the insurer. In case both the parents of the student are earning, he she would be required to declare through a sworn affidavit duly attested by the Notary Public the name of the first parent who is responsible for paying the fee of the insurer. The benefit of protection of fee payable shall be given in case of accidental death of such parent only.” I hereby solemnly aver Contd...2
and undertake that: 1. My Total family income from all sources amounts to Rs--------------only (Rupees ---------------------------). The relevant proof of income in the form of current Income Tax Return/ Certificate of Income from employers of parent(s)/ proof of survey conducted by DRDA of the district or any other authorized Government agency/ any other valid proof (Original /Attested Photocopy) is attached herewith. 2. That my father/ mother/ guardian Mr. /Mrs.------------------------------------is and shall remain responsible for paying my fee during the entire tenure of my course. 3. That my father/ mother/ guardian is working as --------------------- and his/her annual income is Rs. ------------------. 4. That only in case of accidental death of my father/ mother/ guardian, Mr./ Mrs------------------------ the benefit of protection of fee as mentioned on Page No. 94 of the Brochure shall be provided to me. Declared on this ___day of __________ month of ______year.
________________ Signature of deponent Name: ___________________ VERIFICATION Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein. Verified at ---------- (Place) on this --- (day) ----------- of (month) ----------- (year)
Signature of deponent Solemnly affirmed and signed in my presence on this ------- (day) of ---------------- (month) --------------- (year ) After reading the contents of this affidavit. OATH COMMISSIONER
AFFIDAVIT BY PARENT/GUARDIAN I,Mr./Mrs.__________________________________________R/o_________________ am father/mother/guardian of Mr./ Ms-----------------------------,___________________________________________(full name of student with Application Number) having been admitted to Manav Rachna International University, Faridabad ___________________________________________________(name of the course), have read and understood the contents of the Brochure including the policy regarding Group Insurance mentioned on Page No. 94 of the Brochure of Manav Rachna International University Faridabad. That in view of clause (e) mentioned under the heading “ List of other documents to be deposited after the admission” on Page No. 94 of the Brochure AND Further in view of clause 3 mentioned on Page No. 94 of the Brochure which states that “Protection of fee payable upto Rs 4 Lacs for the remaining duration of the course in case of accidental death of the earning parent of the insurer. In case both the parents of the student are earning, he she would be required to declare through a sworn affidavit duly attested by the Notary Public the name of the first parent who is responsible for paying the fee of the insurer. The benefit of protection of fee payable shall be given in case of accidental death of such parent only.” I hereby solemnly aver and declare that: Contd...2
1. My Total family income from all sources amounts to Rs--------------only (Rupees ---------------------------). The relevant proof of income in the form of current Income Tax Return/ Certificate of Income from employers of parent(s)/ proof of survey conducted by DRDA of the district or any other authorized Government agency/ any other valid proof (Original /Attested Photocopy) is attached herewith. 2. That I am and shall remain responsible for paying the fee of my son/ daughter/ ward --------------------------during the entire tenure of his/her course in the University. 3. That I am working as --------------------- and my annual income is Rs. -----------------4. That the benefit of protection of fee as mentioned on Page No. 94 of the Brochure shall be provided to my son/ daughter/ ward only in case of my accidental death Declared on this ___day of __________ month of ______year. ________________ Signature of deponent Name:
___________________ VERIFICATION Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein. Verified at ---------- (place) on this ---(day) ----------- of (month) -----------(year ) -------------------------Signature of deponent Solemnly affirmed and signed in my presence on this ------- (day) of ---------------- (month) --------------- (year) after reading the contents of this affidavit.
OATH COMMISSIONER