जितना आप भर सकते हैं, भरिए। इन ख़ानों के साथ दिख रहा मसौदा साथ-साथ बदलता रहता है, ताकि आप देख सकें कि हर जवाब दस्तावेज़ में क्या करता है।
आप जो लिखते हैं वह इसी ब्राउज़र में रहता है। जब तक आप ख़ुद कॉपी रखने का फ़ैसला न करें, कुछ भी कहीं नहीं भेजा जाता — और यह टैब बंद करते ही वह चला जाता है।
इस फ़ॉर्म के सवाल और उनसे बनने वाला दस्तावेज़, दोनों अंग्रेज़ी में हैं, जबकि यह पन्ना हिन्दी में है। भारत में इस तरह के काग़ज़ आम तौर पर अंग्रेज़ी में ही बनते हैं, और रजिस्ट्रार, बैंक या अदालत में वही शब्द पढ़े जाते हैं जो लिखे गए हैं — इसलिए यह मंच न सवालों का अनुवाद करता है, न उन खंडों का जो इन जवाबों से भरते हैं।
आपके जवाब
अभी कोई जवाब नहीं भरा गया। इस फ़ॉर्म में कुल 19 सवाल हैं।
अभी भरना बाकी है
14 जवाब अभी आने बाकी हैं।
आपने जो लिखा है उसमें कोई कमी नहीं है। दस्तावेज़ बस अभी पूरा नहीं हुआ, और मसौदे में हर उस जगह निशान लगा है जहाँ जवाब आना है।
लाइव मसौदा
मसौदा, अभी जैसा है
यह पूरा दस्तावेज़ है, इसका नमूना भर नहीं। जब भी आप कोई जवाब बदलते हैं, यह दोबारा लिखा जाता है।
लंबी ख़ाली लकीर — __________ — वहाँ खड़ी रहती है जहाँ जवाब नहीं दिया गया। यह जान-बूझकर इतनी साफ़ रखी गई है, ताकि अधूरे दस्तावेज़ को पूरा समझ लेने की ग़लतफ़हमी न हो।
अभी कोई जवाब नहीं दिया गया, इसलिए जहाँ-जहाँ ब्योरा आना है वहाँ ख़ाली जगह खड़ी है। फिर भी दस्तावेज़ की बनावट अभी से पढ़ने लायक है।
AFFIDAVIT AND INDEMNITY BOND FOR A LOST ACADEMIC CERTIFICATE
PART A — AFFIDAVIT OF LOSS
I, __________, __________, resident of __________, do hereby solemnly affirm and declare as under:
That I was issued __________ bearing number __________, by __________, in the year __________.
That the said certificate has been lost under the following circumstances: __________
That despite the following efforts, the certificate could not be traced: __________
That __________
That __________
That the said certificate has not been pledged, deposited, mortgaged or transferred to any person or institution, and remains untraced despite the efforts stated above.
That this affidavit is sworn in support of an application for issuance of a duplicate certificate in place of the one lost.
That the contents of this affidavit are true and correct to my knowledge and belief, that no part of it is false and that nothing material has been concealed therefrom.
VERIFICATION
Verified at __________ on this __________ that the contents of paragraphs 1 to 9 above are true and correct to my knowledge, that no part of it is false and that nothing material has been concealed therefrom.
DEPONENT
_________________ __________
Sworn before __________ at __________ on __________.
PART B — INDEMNITY BOND
I, __________, __________, resident of __________, in consideration of __________ agreeing to issue a duplicate of __________ bearing number __________ in place of the original lost as stated in Part A above, do hereby undertake and bind myself as follows:
That I shall indemnify and keep indemnified __________ against any loss, claim, demand or liability that may arise out of, or in connection with, the issuance of the duplicate certificate, including any loss, claim or liability arising from misuse of the original by any person into whose hands it may come.
That if the original certificate is found, or comes into my possession or knowledge at any time hereafter, I shall immediately inform __________ in writing and surrender the original for cancellation.
That I shall be solely responsible for any consequence arising from any false statement made in Part A above.
IN WITNESS WHEREOF I have signed this indemnity bond at __________ on __________.
AFFIDAVIT AND INDEMNITY BOND FOR A LOST ACADEMIC CERTIFICATE
PART A — AFFIDAVIT OF LOSS
I, __________, __________, resident of __________, do hereby solemnly affirm and declare as under:
That I was issued __________ bearing number __________, by __________, in the year __________.
That the said certificate has been lost under the following circumstances: __________
That despite the following efforts, the certificate could not be traced: __________
That __________
That __________
That the said certificate has not been pledged, deposited, mortgaged or transferred to any person or institution, and remains untraced despite the efforts stated above.
That this affidavit is sworn in support of an application for issuance of a duplicate certificate in place of the one lost.
That the contents of this affidavit are true and correct to my knowledge and belief, that no part of it is false and that nothing material has been concealed therefrom.
VERIFICATION
Verified at __________ on this __________ that the contents of paragraphs 1 to 9 above are true and correct to my knowledge, that no part of it is false and that nothing material has been concealed therefrom.
DEPONENT
_________________ __________
Sworn before __________ at __________ on __________.
PART B — INDEMNITY BOND
I, __________, __________, resident of __________, in consideration of __________ agreeing to issue a duplicate of __________ bearing number __________ in place of the original lost as stated in Part A above, do hereby undertake and bind myself as follows:
That I shall indemnify and keep indemnified __________ against any loss, claim, demand or liability that may arise out of, or in connection with, the issuance of the duplicate certificate, including any loss, claim or liability arising from misuse of the original by any person into whose hands it may come.
That if the original certificate is found, or comes into my possession or knowledge at any time hereafter, I shall immediately inform __________ in writing and surrender the original for cancellation.
That I shall be solely responsible for any consequence arising from any false statement made in Part A above.
IN WITNESS WHEREOF I have signed this indemnity bond at __________ on __________.
पढ़ने का कोई पैसा नहीं। कॉपी अपने पास रखने के लिए खाता चाहिए।
मसौदे की शुरुआत इसी पन्ने पर है, जवाब देते समय। जब सारे जवाब आ जाएँ, तो नीचे दिया बटन पूरा मसौदा खोलता है, जल-चिह्न सहित — तब भी बिना खाते के। छापने पर, या साफ़ कॉपी अपने पास रखने पर ही खाता माँगा जाता है। बात बस इतनी है।
रखी हुई कॉपी किसी न किसी की होनी चाहिए — खाता इसी वजह से है। इससे आगे कुछ नहीं।