I, Shri / Smt …………………………………………………..………..Son of / Daughter of / Wife of
……………………………………………………………. resident of village ……………………………………..…. P.S.
…………..…………………… District ……………………..………… and particulars stated above are true to the best of my knowledge and belief and that they are exhaustive and I have not suppressed any fact. In case it is detected later on that any of the facts stated herein wrong or that I have suppressed some material facts, I shall be liable for prosecution under the relevant law.
