Annexure E
FORMAT FOR AFFIDAVIT
To,
M/s (Name of OMC)
Dear Sirs,
I Mr. / Mrs. …………… son/daughter/wife of Mr ……………. aged …. years, residing at ……………………………………………………….. hereby solemnly affirm as under:
I am in possession of …. cylinders and a pressure regulator of your company for which I do not possess any documents.
I request that the same may be transferred to my name and a fresh consumer number be given and subscription voucher be issued.
I confirm that I am agreeable to submit the documents required for the same and to pay the deposit for the equipment as per your terms.
I hereby undertake to indemnify M/s IOC/BPC/HPC against any claim with regard to the equipment in my possession by any other person at a later date.
Thanking you,
Yours faithfully,
SIGNATURE
NAME
Date:
Place: