Complaint Form Page 2

I…………………………………..S/o………………………………..aged………………..the above named

complainant do hereby solemnly declare that the particulars stated above are

true to the best of my knowledge and belief and nothing has been concealed

therein. I further certify that annexure I,II and III appealed to the complaint are

the true copies of original documents.

Verified at……………..this day

of……………………

(a)………………………Annexure I

Signature of Complainant

(b)………………………Annexure II

(c)………………………Annexure III

(Name of the complainant/Deponent)

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