I, ,
S/o ,
aged about…….. years,
now Residing in …………………………………………………………………………………………….
do hereby solemnly affirm and state as follows:—
1. I am the applicant for license as a Clearing and Forwarding Agent in the
Port of
at Sea in State.
I am well conversant with the facts deposed hereunder and I am fully competent to swear to this affidavit.
I say that, I have got the necessary and prescribed qualifications for acquiring the license as a Clearing and Forwarding Agent of the Port. Also, I fulfill all the statutory requirements for the purpose.
I say that, all the particulars that I have given in the prescribed application form duly filled in and signed and forwarded by me are true to the best of my knowledge, information and belief. Nothing material has been either suppressed or concealed therefrom and no part of it is false.
I say that, there has been no attempt whatsoever, on my part, to mislead the concerned authorities.
I say that, the requisite application fee of Rs
has been duly remitted by me through the treasury and the Challan receipt issued by the Treasury Authorities has been produced alongwith the application.
6. I say that, if I am granted the license to operate and function as a
Clearing and Forwarding Agent, I shall duly and faithfully abide by the
statutory provisions under the Customs Act and the Ports Act, the Rules and Regulations prescribed by the Concerned Authorities from time to time.
SdJ Deponent.
Verification

Verified at on this the day of …..20 ,
that the contents of the above affidavit are true and correct to the best of my knowledge, belief and information and nothing material has been concealed therefrom.

Sd/
Deponent

Solemnly affirmed and signed before me by the deponent, who is personally
known to me, on this the day of , 20

Sdj
Notary