On Stamp of 100/I, ....................................................................

(Name of authorized signatory with

designation) S/O sri .................................................................... R/O .......................................
................................................................................ aged about . years do hereby
solemn affirms and declare as under:1.

That

................................

am

the

authorized

(Hereinafter

referred

signatory
to

as

of

...............................................

the

institute)

located

at

........................................................................................................................................ and has

been authorized by the institute by way of ...........................................................................
(state whether proprietor/ partner/ or is otherwise authorized to sign the present affidavit by
way of resolution dated .................................................................... in case of company or
authority letter or attorney and annex any such resolution/ attorney/ authorization letter etc.)
and as such is competent to sign the present affidavit on behalf of the institute.
2. That the institute is run under .................................................................... registered
under Societies Registration Act, ....................................* (state whether proprietorship
concern/ partnership firm registered under Partnership Act, 1932 / private limited company
or public limited company registered under Companies Act, 1956 / society registered under
Societies Registration Act, 1860 / trust under Trusts Act, 1882 / or any other entity along
with the relevant Statute under which it is registered.) and the certified certificate of
registration/ incorporation is annexed herewith. (Annex a certified true copy of the relevant
certificate of registration / incorporation with the relevant registering / incorporating
authority*)(For proprietorship concern, certificates from sales tax, service tax or any other
authority or certificate from Shops and Establishment Acts under various state government be
annexed or in the absence of all above a certificate from the bank that an account exists in the
name of proprietorship concern be annexed.)(*- Not applicable for proprietorship concerns).
9oi
3. That the information / contents provided in the Application Form for grant of
permission to conduct DIPLOMA and/or UNIVERSITY COURSES and the attached
documents submitted by me are true and correct and that it conceals nothing and that no part
of this is false.

4. That the institute undertakes that it will abide by the rules and regulations of IICT
ALLAHABAD and would also abide by the guidelines as issued by IICT ALLAHABAD
from time to time for the smooth conduct of DIPLOMA and UNIVERSITY COURSES and
otherwise also.
5. That the institute undertakes that it will indemnify IICT ALLAHABAD for any
liability arising out of any liability that might arise during the continuance of DIPLOMA and
UNIVERSITY COURSES during the time when the permission is given by IICT
ALLAHABAD for conduct of DIPLOMA and UNIVERSITY COURSES to the institute or
even after withdrawal of such permission by IICT ALLAHABAD due to any reason.
6. That in case the contents of this Affidavit are found to be incorrect or false, I shall
be liable for action under the relevant provision of law. Besides any action that may be taken
against the institute such as withdrawal of accreditation or imposing any penalty amongst
others.

(Signature of the Applicant)

Deponent:

Verification: Verified at (place of execution of affidavit) on this (date of execution of

affidavit) that the contents of my above affidavit are true and correct of my knowledge and
nothing has been concealed there from.

(Signature of the Applicant)

Deponent: