Format of Undertaking for Handicapped Pension

Format of Undertaking for Handicapped Pension

Birth Certificate Affidavit FormatThis is certify that the under mentioned particulars are correct and true solemnly declare that the documents submitted by me are true and details is given as under: –

NAME                                               :    _________
FATHER’S NAME                         :    _________
RESIDENTIAL ADDRESS          :    _________
CATEGORY                                     :    HANDICAPPED
ELIGIBILITY                                 :    I AM HANDICAPPED PERSON ABOVE _________

This is also certify that I have no source of incomes and direly need of pension recommended by the _________  and I have not applied/not taking any pension from any Organization i.e. _________  Government/Central Government /any _________  except this pension I am also residing _________  for more than _________  years.

All the above details are true and correct and nothing has been concealed if any instant is noticed in this regards i will be fully responsible for the same.

APPLICANT

Format of Pension Undertaking Old Age

Format of Pension Undertaking Old Age

Birth Certificate Affidavit FormatThis is certify that the under mentioned particulars are correct and true solemnly declare that the documents submitted by me are true and details is given as under: –

NAME                                               :    _________
FATHER’S NAME                         :    _________
RESIDENTIAL ADDRESS          :    _________
CATEGORY                                     :    OLD AGE
ELIGIBILITY                                 :    MY AGE IS _________

This is also certify that I have no source of incomes and direly need of pension recommended by the _________  and I have not applied/not taking any pension from any Organization i.e. _________  Government/Central Government /any _________  except this pension I am also residing _________  for more than _________  years.

All the above details are true and correct and nothing has been concealed if any instant is noticed in this regards i will be fully responsible for the same.

APPLICANT

Format Of Application Undertaking For Water Connection

Format Of Application Undertaking For Water Connection
Format Of Application Undertaking For Water Connection

1. I/ We shall install ISI Water Meter of requisite specifications as per the requirements of the __________ Board at my /our own cost, if it is not provided by __________ Board.

2. I / We shall install Water connection within a period of __________ days from the date of sanction.

3. I / We shall be liable to pay the outstanding dues pertaining to disconnected water connection, if any and development charges (water/sewer) for the same premise.

4. I/We shall be liable to pay the outstanding dues on the water connection existing in the name of previous owner/occupier of the premise.

5. I / We shall be liable for the forfeiture of advance, security and development charges and also cancellation of sanction of water connection / disconnection of unauthorized water connection, if particulars furnished above are found to be wrong at the time of inspection by the Officers of the __________ Board.

6. I/ We shall install the water connection including pipes, fittings, etc, from ferrule to the premise through licensed Plumber OR any qualified engineer executing work to the satisfaction of the
__________ Board and will intimate the name and address of such plumber / engineer to __________
Board, if required.

7. I / We shall pay road restoration charges to the Competent Authority.

8. I / We agree that sanction of water connection or payment of development charges would not condone the illegality or unauthorized construction and liability of action in consequence thereof and would not, in itself, entitle the applicant for claiming any right, title or claim in respect of the premises.

9. I / We shall abide by the provisions of the __________ Water Board Act, ________ and Rules / Regulations framed or orders, directions issued there under.

10. I / We shall be responsible for civil and criminal liability if particulars furnished are wrong, OR
Undertaking given herein is not discharged properly.

Signature of Applicant(s)

Format of Application Undertaking for Sewer Connection

Format of Application Undertaking for Sewer Connection
Format of Application Undertaking for Sewer Connection

1. I shall install sewer connection within a period of _________ days from the date of sanction.

2. I shall be liable to pay all outstanding dues to _________ on account of existing / cut off  sewer connections, development charges if any in the name of previous owner/occupier of the premises.

3. I shall be liable for the forfeiture of advance, security and development charges and also cancellation of sanction of sewer connection / disconnection of unauthorized sewer connection, if, particulars furnished above are found to be wrong at the time of inspection by the Officers of the _________.

4. I shall install the sewer connection for the premises through Licensed Plumber as per guidelines of _________ and will intimate the name and address of such Plumber to _________.

5. I shall pay road restoration charges to the Concerned Authority.

6. I agree that sanction of sewer connection or payment of development charges, or payment of any other outstanding dues would not condone the illegality or un-authorized construction and liability of action in consequence thereof and would not, in itself, entitle the applicant for claiming any right, title or claim in respect of the premises.

7. I shall abide by the provisions of the _________ Board Act, _________ and Rules/Regulations framed or orders, directions issued there under.

8. I shall be responsible for civil and criminal liability, if particulars furnished are found wrong, or Undertaking given herein is not discharged properly.

Signature of Applicant
Name: _________
Address: _________