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AFFIDAVIT / SELF DECLARATION I S/o / D/o Age Years R/o do hereby solemnly af rm and declare that 1. I am father of Mr. / Ms. who intend to appear in the admission test on 25th January 2009 and thereafter join the course called FORTUNATE 40 in case qualify a social initiative by FIITJEE to ensure success for the economically deprived. Mr. AFFIDAVIT / SELF DECLARATION I S/o / D/o Age Years R/o do hereby solemnly af rm and declare that 1. I am father of Mr. / Ms. who intend to appear in the admission test on 25th January 2009 and thereafter join the course called FORTUNATE 40 in case qualify a social initiative by FIITJEE to ensure success for the economically deprived* Mr. / Ms. name of the student is studying in Class last examination in class Mention the Standard in which appeared last. My occupation is. I am employed with in case of employee / nature of activity The name of the spouse of the undersigned is Mr. / Mrs. whose occupation is The total numbers of members in our family are. The total family income including income of spouse wherever applicable is Rs. Rupees per month. Deponent VERIFICATION Veri ed on the date that the contents stated above are true and correct to the best of my knowledge and belief and nothing material has been concealed therefrom* ATTESTATION This is to certify that the above declaration is true and correct to the best of my knowledge information* Designated Of cial. I am father of Mr. / Ms. who intend to appear in the admission test on 25th January 2009 and thereafter join the course called FORTUNATE 40 in case qualify a social initiative by FIITJEE to ensure success for the economically deprived* Mr. / Ms. name of the student is studying in Class last examination in class Mention the Standard in which appeared last. / Ms. name of the student is studying in Class last examination in class Mention the Standard in which appeared last. My occupation is. I am employed with in case of employee / nature of activity The name of the spouse of the undersigned is Mr. My occupation is. I am employed with in case of employee / nature of activity The name of the spouse of the undersigned is Mr. / Mrs. whose occupation is The total numbers of members in our family are. The total family income including income of spouse wherever applicable is Rs. / Mrs. whose occupation is The total numbers of members in our family are. The total family income including income of spouse wherever applicable is Rs. Rupees per month. Deponent VERIFICATION Veri ed on the date that the contents stated above are true and correct to the best of my knowledge and belief and nothing material has been concealed therefrom* ATTESTATION This is to certify that the above declaration is true and correct to the best of my knowledge information* Designated Of cial. I am father of Mr. / Ms. who intend to appear in the admission test on 25th January 2009 and thereafter join the course called FORTUNATE 40 in case qualify a social initiative by FIITJEE to ensure success for the economically deprived* Mr. / Ms. name of the student is studying in Class last examination in class Mention the Standard in which appeared last. My occupation is. I am employed with in case of employee / nature of activity The name of the spouse of the undersigned is Mr.

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