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Affidavit For Other State Diploma Degree and Gap

The affidavit is a declaration by Chauhan Jitendra Bhola, a 24-year-old resident of Mumbai, regarding his educational qualifications and intent to register with the Maharashtra State Pharmacy Council. He confirms completing his education in Maharashtra and Uttar Pradesh, has not yet applied for registration, and will inform relevant authorities if he migrates to another state. The affidavit also includes assurances about the authenticity of his educational documents and awareness of the legal implications of any false information.

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31 views2 pages

Affidavit For Other State Diploma Degree and Gap

The affidavit is a declaration by Chauhan Jitendra Bhola, a 24-year-old resident of Mumbai, regarding his educational qualifications and intent to register with the Maharashtra State Pharmacy Council. He confirms completing his education in Maharashtra and Uttar Pradesh, has not yet applied for registration, and will inform relevant authorities if he migrates to another state. The affidavit also includes assurances about the authenticity of his educational documents and awareness of the legal implications of any false information.

Uploaded by

nikhilchauhan3031
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Affidavit Format A

ON STAMP PAPER OF RS 100/-


DIPLOMA / DEGREE FROM OTHER STATE / GAP AFFIDAVIT

I CHAUHAN JITENDRA BHOLA age 24, residing at GURU PRASAD CHAWL, MURUM
KHAN NAGAR, MALVANI CHURCH, MARVE ROAD, MALAD (WEST), MUMABI pin
400095 do hereby state and declare on solemn affirmation as under:-
1. I am a resident of GURU PRASAD CHAWL, MURUM KHAN NAGAR, MALVANI CHURCH, MARVE ROAD,
MALAD (WEST), MUMABI-400095

2. I did my all education upto S.S.C. in the year 2015 in the state of MAHARASHTRA. from ST. ANTHONY
HIGH SCHOOL, MALWANI CHURCH, MARVE ROAD, MALAD (W), MUMBAI-400095 after that I did my H.S.C.
in the year 2017 in the state of MAHARASHTRA from NALANDA JUNIOR COLLEGE, PLOT No.2, RSC-34,
GORAI-2, BORIVALI (W), MUMBAI-400091 After that I did my D.Pharm / B.Pharm In the state of
UTTARPRADESH from VIMALA SHANKAR PHARMACY COLLEGE, AKAWAS PATTI, BHITARI, GHAZIPUR,
UTTARPRADESH-233304 University BOARD OF TECHNICAL EDUCATION,UP, LUCKNOW.

3. So far I have not applied to any state Pharmacy Council in India for registration under PharmacyAct,1948
and hence I have not been granted the registration by any State Pharmacy Council in India.

4. In case,in future if I migrate to some other State other than the Maharashtra I will inform the
Maharashtra State Pharmacy Council as well as other concerned State Pharmacy Council that I have
originally registered myself in Maharashtra state and wish to transfer to the concerned State.

5. I also assure and affirm on oath that I had completed my D.Pharm/B.Pharm /Pharm.D course after duly
complying with the Provisions of Education regulations laid down by Pharmacy Council Of India,New Delhi
and also assure that all the Pharmacy educational documents produced and submitted by me for
pharmacist registration to Maharashtra State Pharmacy Council are genuine,I am aware that If any of this
documents are found to be false in any verification,I will be liable for action as per law.Also anytime in
future if it is found that approval period of my D.Pharm/B.Pharm/Pharm D. admission do not fall under
section 12 of the Pharmacy Act 1948 my pharmacist registration is liable for cancellation under section
36(1) of the Pharmacy Act 1948.

6. I am aware of the provisions of section 36 of Pharmacy Act regarding penal removal of name from the
register in case of professional misconduct.

7. I affirm that I am not Suppressing any of the material fact in my declaration here in above mentioned
and are true and genuine to the best of my knowledge and belief.
Solemnly affirmed at MUMBAI this 13TH day of JULY 2024

Deponent

Explained and Identified by me. (Sign of applicant)

Advocate Before me

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