DEPENDENT CERTIFICATE AFFIDAVIT
Executed at Jalandhar on 1 April 2026.
I, Simranjit Kaur, daughter of Sh. Gurmeet Singh, resident of House No. 212, Guru Nanak Nagar, Jalandhar, Punjab 144001, holding Aadhaar 4444 5555 6666, ordinarily resident within the State of Punjab (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:
- 1. THE SPONSOR
1.1 I am the person named in paragraph 1.2 below, who is the sponsor.
1.2 Sh. Balwinder Singh is an ex-serviceman.
1.3 The particulars of that service or membership are: Havildar, Sikh Regiment, retired 2012; service number and PPO number as printed on the discharge book / PPO.
- 2. THE DEPENDANTS
2.1 The following persons are dependent on Sh. Balwinder Singh for their maintenance:
- 1. Gurpreet Kaur, wife, 58, lives with him; 2. Manpreet Singh, son, 22, full-time student, no income
2.2 I declare that none of the persons named in paragraph 2.1 has any independent income of their own.
- 3. PURPOSE
3.1 This affidavit is sworn in support of an application for a dependent certificate, needed for: Enrolment of dependants at the ECHS polyclinic, Chandigarh.
3.2 I undertake to inform the receiving office if any person named above ceases to be dependent, marries, starts earning, or dies, or if any other particular stated here changes, and I understand that the certificate may be withheld or cancelled if any statement made here is found false.
- 4. DECLARATION
4.1 Every statement made above is true to my own knowledge and belief, and I have concealed nothing material to this application. I am aware that making a false declaration in an affidavit is an offence.
VERIFICATION
Verified at Jalandhar on 1 April 2026 that the contents of paragraphs 1 to 4 above are true and correct to my own knowledge, that no part of it is false, and that nothing material has been concealed.
DEPONENT
Signature: ______________________________
Simranjit Kaur
ATTESTATION
Solemnly affirmed and signed before me on 1 April 2026 at Jalandhar, the Deponent having been identified to my satisfaction by Aadhaar 4444 5555 6666.
Notary Public / Oath Commissioner
Registration No. and seal: ____________________