AFFIDAVIT
I Mrs./Mr. _______W/o/D/o Sh .___________solemnly affirm as under:-
I am a Partner in ________________[Partner name] having its office at ___________[Office Address where the gas connection is]
I have a Gas Connection vide consumer _____________[Ex. No SG-48297] from _________[Ex. M/s Pankaj Gas Service ] ______________[gas Agency Address] .
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 __________[Gas Agency name] 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]
[PAN ABCDE12345]
Date ________, [City]
Witness
