Day of July 1961, at ..........., by Occupation I ............ Resident of ....... Telephone No......., Office

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ANNEXURE- OR-6

AFFIDAVIT

I, .............Son of ........... Aged 54 years, Born on 3rd


day of July 1961,at ...........,by occupation I ............
resident of .......Telephone no.......,Office Address
at .............................. do hereby solemnly affirm
and declare on oath as follows:

1. That the State Bank Of India, a Bank Established under


State Bankof India Act, 1955 having its Branch at ...........
(hereinafter reffered to as Bank) has at my request
granted/and/or/agreed to grant credit facilities to the
borrower ..................., inter alia, against my
guarantee and hence, this affidavit is being sworn by me to
satisfy the bank abount my worth/financial Position.
2. That followings are my statement/ detials of assets & liabilities as on 30
day of June 2016:-

a. DETAILS OF IMMOVABLE PROPERTIES

Place Where land or building is Ancestral or self If Extent of Market Whether whether
situated acquired/belonging encumbere land in Acres Value in any agricultur
in individual d to what Rupees case/suit al or non
name / in joint extent) before agricultur
names (if any al and
ancestrals/in joint compete weather
names,specify nt comes in
share thereof) authority ceiling
in area
respect
of the
immovab
le
property
is
pending

PLACE: PATNA

VILLAGE:

TALUKA :

POLICE STATION:

REGISTRATION:

SUB- DISTRICT:

DISTRICT:

SURVEY NO.:
PLOT NO:

DOOR NO :

NAME OF STREET : NAGLA


MAIN ROAD
MOUZA :

KHATIAN NO:

BOUNDED BY :

NORTH :

SOUTH :

EAST :

WEST :

b. LIQUID ASSETS

PARTICULARS Description Amount


If Encumbered to what Extent
Cash in hand
Bank Balance
POST OFFICE

c. GOVERNMENT SECURITIES

PARTICULARS Description Amount


If Encumbered to what Extent

d. SHARES

PARTICULARS Description Amount


If Encumbered to what Extent

THERE IS NO INVESTMENT IN SHARE & SECURITIES


e. LIFE INSURANCE POLICIES :

PARTICULARS Description Amount


If Encumbered to what Extent

f. JEWELLERY & ORNAMENTS VALUE IS RS.261349.51

g. INVESTMENT IN BUSINESS, IN ASSOCIATES FIRM,IF ANY

PARTICULARS Description Amount


If Encumbered to what Extent
Fixed Assets

OTHER INVESTMENT
LOAN & ADVANCES

h. Income Per Month

i. LIABILITIES

PARTICULARS Description Amount REMARKS


i) BORROWINGS FROM
BANKS: -
ii) BORROWINGS FROM
MARKET: -
iii) BORROWINGS FROM
OTHER SOURCES: -
iv)ASSUMED INDIRECT
LIABILITY -

3. That I undertake and declare further to notify to the State bank Of India,
Patna City Branch, any Change, weather by way of increase or diminution, in
the assets/liabilities as detailed above every year by way of presenting
audited balance sheet for the period.

4. That the statement/ decleration made in this affidavit in paragraphs 1 to 3


above are true to my knowledge.

Deponent:
Date:

Deponent is identified by..................


Deponent is identified by..................

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