Format of Affidavit for Loss of Subscription Voucher
I, _________ Son/Daughter/Wife of _________ Resident of _________, Hereby solemnly confirm and declare:
That I was issued a gas connection at consumer No. _________ Vide subscription Voucher No. _________ dated _________ from M/s _________ Gas Agency.
The said voucher has been misplaced/Lost by me and in the event if it is found, I shall arrange to surrender the same to the corporation/distributor I shall not misuse the said voucher I indemnify _________ and it’s distributor of claim, if any against the above said subscription voucher
DEPONENT
VERIFICATION:
Verified at Delhi on this _________ day of _________ that the contents of this affidavit are true and correct to the best of my knowledge and belief and nothing has been concealed therein.
DEPONENT