Application Form For Claiming Unemployment Allowance (Page 3 of 4) in pdf

Application Form For Claiming Unemployment Allowance Page 3

AFFIDAVIT

(For claiming unemployment allowance sanctioned vide Punjab

Government Employment Department Notification No.128-5L & E-79, Dated 11

January 1979, and as amended from time to time.)

I ______________________ son/ daughter/ wife of _______________

(Name of the claiment) and permanent resident of ____________________________

_____________________________________________________.

(Complete postal address)

Do hereby solemnly affirm and declare as follows:-

That my name is registered for employment assistance with Employment

Exchange ______________ vide particulars given in my attached application form.

That I claim unemployment allowance for the period from __________ to

______________.

That I was not gainfully employed during the period shown in Item-2

above in any Government/ Quasi Government Department/ Local Body/ Private

Establishment or in any kind of self employment whether independently or with my

family.

That I was never dismissed from Government service or from the service

of any public sector undertaking including corporations, Quasi Government Institutions,

statutory bodies and local bodies etc.

That I was never convicted of a cognizable offence involving moral

turpitude.

That I have not been receiving any pension, scholarship or financial aid

from any source during the period of my claim as mentioned in item 2 above.

That I have not been receiving education in any recognised educational

technical or professional institution during the period mentioned in item 2 above.

That my permanent place of resident is in Punjab and that I have been

residing in Punjab for at least 6 months in the year proceeding the date of my enclosed

application form.

Application Form For Claiming Unemployment Allowance Page 3