BEFORE THE INCOME-TAX OFFICER, _______________

Affidavit of Mr. A aged about ____ S/o Mr.___________, resident of __________________________.

I, the above named deponent solemnly affirm and state as under in the case for the Assessment Year ________.

1. That the deponent is the proprietor of the firm named _________________________ and hence is fully conversant of the facts deposed below;

2. That the deponent draws his income from the firm named above.

3. That the deponent started the above industry about __ years back to earn the livelihood for himself and his family and purchased one old machine from his friend named M and made payment of Rs. _________.

4. That during the assessment year under consideration the deponent felt the need of extending this Industry and added one new machine which the purchased for Rs. ___________. Therefore, total investment in the industry worked out as under;

(a) Starting investment Rs. 5,000.00

(b) Subsequent investment Rs. 15,000.00

Rs. 20,000.00

5. That the deponents income for the preceding three years on estimate basis is as under;

1986-87 12,000.00

1987-88 13,500.00

1988-89 14,000.00

6. That the deponents standard of living is very simple and his two sons are major and are not dependent on the deponent, hence personal drawing of Rs. ______ during the year is more than sufficient for his small family of wife and husband.

7. That the deponents Bank account is in the __________ Bank. The balance as on 31st March, _______ is Rs. ____________ for which a Bank certificate is enclosed as Annexure A

Dated Deponent
Verification

I, A, the above named deponent to hereby verify that the contents of this affidavit from paras 1 to 7 are true to the best of my knowledge and belief. Nothing material has been concealed.