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Annexure-1

The written declaration as given hereunder will be included at theend of the application form for geiting Unemployment Allowanl.i - ---

Son/

the informtion given above and in the enclosed documents is true to thebest of my knowledge and belief and nothing has been concealed therein.I am well aware of the fact that if the information given by me is provedfalse/not true, I will have to face the punishment as per the law. Also, allthe benefits availed by me shail be summarily withdrawn.

Signature of applicant

Affix recentphotograph of the

applicant withsignature

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