Annexure I

THE AFFIDAVIT (for Hindi Linguistic Minority Quota only)

(To be typed on Rs.100/- Stamp Paper)
THE AFFIDAVIT FOR CANDIDATES

I, Mr./Ms.______________________________aged _______years Indian Inhabitant (Name of Candidate)

of ___________________________residence _____________________________
(City and State) (Permanent Residential address)
___________________________________ do hereby state and declare on solemn affirmation as under:-
I say that __________________________________, / I was born on _____________ at
(Name of Candidate) (Date of birth)
________________ Mumbai and since then I am permanently residing at _________
(Place of Birth)
________________________________________________________ say that my family members belong to Hindi
Linguistic Minority community by birth.

I say that I ______________________________ belong to Hindi Linguistic Minority

(Name of Candidate)
Community by Birth and caste. Following documents enclosed for confirmation of Hindi Linguastic Minority
Community.
I am submitting the following documents as proof for my eligibility for Hindi Linguastic Minority as per mentioned in
Sr. 14 of Page No. 2 of the Admission Form.

1) Affidavit on Stamp paper of Rs.100/- as per format available in College office for Hindi Linguastic
Minority.
2) Certificate issued by Principal/Head Master of Junior College/Higher School for Mother Language
3) Paternal educational proof of Hindi langauge.

I am making this affidavit in order to produce before the concerned authorities i.e. Smt. Kamaladevi G. Mittal
Punarvasu Ayurved Mahavidyalaya, Mumbai to enable me to get the admission in 1st B.A.M.S. in Smt. Kamaladevi
G. Mittal Punarvasu Ayurved Mahavidyalaya, Mumbai under Hindi Linguistic Minority quota.
Whatever stated hereinabove is true and correct to the best of my knowledge and belief. If found false, I shall be liable
for cancellation of my admission alongwith penal action to be taken as per law at my own responsibility.

Solemnly affirmed at ____________ on this _________2016.

(Place of affidavit) (Date of affidavit)
Deponent

Before me

(Signature of the Notary/Magistrate)

 Annexure II
For Candidates belonging to Hindi Linguistic Minority
CERTIFICATE.

This is to certify that Mr. / Miss __________________________________

was bonafied student of this School / Junior college. He/She passed Std. X/Std. XII
examination from this School / Junior College. His / Her mother tongue is ____________
verified from the School / Junior College record.
This certificate is issued for the purpose of his / her admission in Smt.K.G.Mittal.P.Ayurved
College, Mumbai-2 for First year Degree Course of B.A.M.S. (Ayurved) for the academic
year 2016-17.

Outward No. & Date

Place:
Signature of Principal/Head Master
Junior College/ School

Seal of the College.

Note: Principal of the College / School competent to issue this certificate college will be
responsible submitting the correct record of this certificate