I Mrs./Mr. ………. W/o/D/o Sh ……. solemily affirm as under:-
I am a Partner in M/s Kayam Security & management Services having its office at 1st Floor DDA Market, Janakpuri District City Centre, New Delhi.
I have a Gas Connection vide consumer No SG-48297 from M/s Pankaj Gas Service (……Address………) New Delhi.
I have lost original Security Deposit Receipt/Booking Papers and now want to apply for an additional cylinder to convert my existing single connection into Double Cylinder connection.
I undertake to indemnify M/s Pankaj Gas Service for issuing me a Duplicate Deposit Receipt/Booking papers.
Verification. I Mrs./Mr. …….. do hereby declare that what is stated above is true to the best of my knowledge & belief.
(Name & Signature)
Date ________New Delhi