Page 241 - STATE v ARIF & ORS. SC-NO-540-2022 PART 1

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( AFF.IDA.VIT)

~' NIYAZ . .A!IM'D XA'W~~ l!\,1!1 !?f !>!~ ~!4 ~~~~ ~.~• ~.SI~H 0~ llHKADAt
QUT\JB DIN RlRA, S!Il'IAGAR, do hP.reby solemnly affirm that I have
filled up an application dated o?fl\1 \9~9 for going abroad for
Bl.!.SVne&~ I take on oath and l sdemnly declare that the
partio~ars f~rnished by me in my said passport apPlication form
are true and correct and I have not ~oncealed or misrepresented
facts in it.
Tl:at I am the citizen of india by birth I have neither
been deprived of the citizenshiP of india.

2* That I have not been convicted by a court in india fol
any criminal offence and sentenced to imprisonment at

time d~ring the period of five years.
3* That. I de.elare thatno cfiminal proceedings are p~~n
against me in ary co1.1rt 1n indi!l· v\}<S'al <;;::/;
"~ 1 ce 1
4* I take an oath that no warrent or samon£> "'!l'L '{f;"
tl'~\~ (
-ence or a warrent for my arrest or any ~~~·f,~ll.a
1
~ ~~~: .'<\0'1'1'"
-ting my departure from india been issu~~~~~C'UUr·
-t. ~·
5* I have never repatriated from abroad at aovt.expenses.
6* I take an oath that I em not holding any other passpor1

That r am fully awear that undersection 12 of the Act
1967 it iS a penal offen=e to knowlingly furniSh any
false information or s~ppress material information.

9* That my date of birth

:.. -~'"~12!.--~ tho:t t!le stattmU:ra:
p· tk "~ cl>c':': hos~#><CiH;iOn :-
~~_:· ~ iY](!I~01}'e'itJ1~~- that the contats of thiS affidavit ue true and correct
1
!J' Akt .tyL {,.tJ?,)=f~··.~st of my knowledge and nothing has been concealed therein.
r · .. · tL(/''1~• ·t-r' 'lt-bi-·.-.o
.. ·· ... ·-'l-l'"' 1.? .<7.1 •. ~.
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