AFFIDAVIT
I, ______________________________ , Son / Daughter / Wife of ______________________________ , aged ___ years, residing at ______________________________ do hereby solemnly affirm and state as follows:
I am the absolute owner / sole lawful holder of the piece and parcel of vacant plot bearing Plot No __________________________ with an extent of __________________________ Sq Feet in the __________________________ Survey No (S) 314/2, 314/3 & 314/8A situated at __________________________ Village ,__________________________ Taluk, __________________________ District with in the registration district of __________________________ and Sub registration district of __________________________
The original registered document relating to the above property, namely:
Document No __________________________ / __________________________ /Block 1/__________________________ / __________________________ Year: 2006__________________________ Registered at: __________________________ Sub-Registrar Office
has been lost / misplaced by me.
I state that while carrying the document for official purposes such as xerox, consultation, patta transfer, property tax related work and other property-related activities, the said original document was inadvertently lost / misplaced.
In particular I took xerox of totally 6 land documents on 12th May at 3 pm in __________________________ Xerox shop , __________________________ , Chennai – 600 037 opposite to __________________________ chance of missing at this place is high as all documents mixed.
On ______________________________ I noticed only this document alone is missing , I made diligent search for the said document at all possible places, but I am unable to trace the same till date.
I have lodged a complaint regarding the loss of the document before V7 __________________________ Police Station with the Inspector of Police .
I further state that the said original document has not been pledged, mortgaged, deposited, transferred or otherwise dealt with by me in favour of any person, bank or financial institution.
In the event the original document is traced in future, I undertake to produce the same before the appropriate authority if required.
I am executing this affidavit to place the true facts on record and for the purpose of obtaining certified copies and for future reference.
Solemnly affirmed at __________________________ this 23rd day of __________________________
DEPONENT
(Signature)
Before Me
WITNESSES:
1.
Name, address and signature
2.
Name, address and signature
