ਆਪਣੀ ਜਾਣਕਾਰੀ ਭਰੋ

UNEMPLOYMENT / SOLE-EARNER AFFIDAVIT

I, __________, __________, resident of __________, holding __________, ordinarily resident within __________ (the "Deponent" or "I"), do hereby solemnly affirm and declare as follows:

1. 1. MY POSITION

1. 2. PURPOSE

2.2 I undertake to inform the person or office to whom this affidavit is given if my position stated above changes before it is acted upon, and I understand that any benefit granted on the strength of a false statement here may be withdrawn.

1. 3. DECLARATION

3.1 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

DEPONENT

Signature: ______________________________
__________

ATTESTATION

Notary Public / Oath Commissioner
Registration No. and seal: ____________________