Format of affidavit to be made on a non-judicial stamp paper of Rs.100/- (Rupees One Hundred Only)

before a Notary or a Executive Magistrate or a Metropolitan Magistrate.

To be filled in by the candidate, who has completed 18 years of age.

AFFIDAVIT

I, ……………………………………………………………………… an Indian inhabitant, residing at

…………………………………………………………………………………………………………....

…………………………………………………………………………………………………………....

son/daughter of Mr. ……………………………………………………………….…………………….

an Indian inhabitant, residing at ………………………..………………………………………………

…………………………………………………………………………………………………………....

do hereby solemnly affirm and say that I belong to the Gujarati speaking Community, which is

a linguistic minority in the State of Maharashtra.

Solemnly affirmed at ..................................................…..this …………….......................day of

……………………………….., 2012.

…………………………………….

(Signature of Candidate)

Before Me

…………………………………………….

To be filled in by the father / mother / guardian of the candidate who has not completed 18 years of age

AFFIDAVIT

I, ……………………………………………………………………… an Indian inhabitant, residing at

……………………………………………………………………………………………………………

……………………………………………………………………………………………………………

Father/Mother/Guardian of ……………………………………………………………………………  

aged ........ years and ............. months an Indian inhabitant, residing at ……………………….....

…………………………………………………………………………………………………………..

……………………………………………………………………………………………………………

do hereby solemnly affirm and say that my son/ daughter /ward belongs to the Gujarati

speaking Community, which is a linguistic minority in the State of Maharashtra.

Solemnly affirmed at ..................................................…..this …………….......................day of

……………………………….., 2012.

…………………………………….

(Signature of Father / Mother / Guardian* of the Candidate)

…………………………………….

* Relationship with the candidate

Identified by

…………….........................................

…………………………………………