------------------------------------------------------------------------------------------------------------------------- I________________________________ s/o-d/o____________________________ r/o________________________________________________. age about _____________ years , do hereby solemnly affirm and declare as under;-

That I have not taken benefit more than twice under the ‘’ Ministry of Social Justice and Empowerment, Government of India” for Free Coaching scheme for SC and OBC candidates for the UPSC Civil Services Examination.

That I undertake to abide by all rules and regulations of the scheme.

Deponent

VERIFICATION

Verified at______________ on this _________ day of _________ 2017 that the contents of my above affidavit are true and correct to my knowledge and nothing material has been concealed therefrom.

DEPONENT