(To be printed on Non-Judicial Stamp Paper of Rs. 10/- or Rs. 20/-)
I, [Your Name], S/o / D/o [Father's Name], aged about [Age] years, resident of [Full Address], do
hereby solemnly affirm and declare as under:
That I am a resident of the above-mentioned address and am correctly identified by the
executant.
That I have passed my [Name of Last Exam, e.g., Class 12th / Graduation] from [Name of
School/College/University] in the year [Year of Passing].
That after passing the said examination, I did not join any other educational
institution/college/university for further studies from [Start Year of Gap] to [End Year of Gap].
That the reason for my gap period was [Reason for Gap, e.g., Preparation for Competitive
Exams / Medical Reasons / Financial Issues].
That during this gap period, I was not involved in any illegal or criminal activity and there is no
criminal case pending against me in any court of law.
That I was not debarred from any university or educational institution during this period.
That the information given above is true and correct to the best of my knowledge and belief, and
nothing has been concealed therein.
Deponent
(Signature)
VERIFICATION:
Verified at [Place] on this [Date] day of [Month, Year], that the contents of the above affidavit are
true and correct to the best of my knowledge and nothing has been concealed or falsely stated.
Deponent
(Signature)