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Annexure: IV

AFFIDAVIT BY PARENT/GUARDIAN
(To be executed on Non-Judicial Stamp Paper worth of Rs. 50/- or appropriate value in case of
state other than Assam)
I, Mr./Mrs./Ms. _____________________________________________________ (full name of
parent/guardian) father/mother/guardian of , (full name of student with
admission/registration/enrolment number) ,having been admitted to ____(name of the
institution) , have received a copy of the UGC Regulations on Curbing the Menace of Ragging in
Higher Educational Institutions, 2009, (hereinafter called the “Regulations”), carefully read and
fully understood the provisions contained in the said Regulations.
2) I have, in particular, perused clause 3 of the Regulations and am aware as to what constitutes
ragging. 3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am
fully aware of the penal and administrative action that is liable to be taken against my ward in
case he/she is found guilty of or abetting ragging, actively or passively, or being part of a
conspiracy to promote ragging.
4) I hereby solemnly aver and undertake that
a) My ward will not indulge in any behaviour or act that may be constituted as ragging
under clause 3 of the Regulations.
b) My ward will not participate in or abet or propagate through any act of commission or
omission that may be constituted as ragging under clause 3 of the Regulations.
5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to
clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken
against my ward under any penal law or any law for the time being in force.
6) I hereby declare that my ward has not been expelled or debarred from admission in any
institution in the country on account of being found guilty of, abetting or being part of a
conspiracy to promote, ragging; and further affirm that, in case the declaration is found to be
untrue, the admission of my ward is liable to be cancelled.

Declared this ___day of __________ month of ______year.

Signature of deponent
Name:
Address:
Telephone/ Mobile No.:

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the
affidavit is false and nothing has been concealed or misstated therein.
Verified at …………….(place) on this the……. (day) of ………..(month), ……..(year) .

Signature of deponent
Solemnly affirmed and signed in my presence on this the (day) of (month), (year) after reading
the contents of this affidavit.

OATH COMMISSIONER
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