AFFIDAVIT

I __________________________________ S/O _____________________________________________

Resident of _________________________ serving BUITEMS as _______________________________
declare on solemn affirmation as under:1.

That

received a laptop with related accessories ________________________________

_____________________________________________________________________________________
from BUITEMS with a cost amounting Rs._________________ ( Rupees ________________________ )
under its Laptop Scheme on loan, to be recovered from my monthly salary in twelve equal installments.
2.

That in case of my resignation from service or termination/dismissal/removal from service or

proceeding on EOL, or leaving BUITEMS service to join another job, the whole outstanding amount of
loan as mentioned above will be deposited/repaid to BUITEMS in lump sum by me.
3.

Whatever stated above is true to the best of my knowledge and belief and nothing has been

concealed.
Signature _____________________________
Name ________________________________
N I C No. _____________________________
Date _____________ Place _______________
I/ We the Sureties declare, unconditionally and with free consent, as under:If,
due
to
any
reason
thereof,
the
borrower Mr./Ms ____________________
S/O-D/O _________________________ serving BUITEMS as __________________________________
fails to repay the loan or any part thereof, I/ We shall pay the Whole Outstanding amount to the
BUITEMS in lump Sum immediately on demand.
Surety No.1

Surety No.2

Signature___________________________

Signature_________________________

Name___________________________

Name____________________________

Designation_______________________

Designation________________________

N I C No.________________________

N I C No.__________________________