AFFIDAVIT BY THE STUDENT
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l)￨′
(lull nome of srudenl wilh odmission/regislrolion/enlolment numbe, s/o d/o
Mr./Mrs./Ms.
hoving been odmitled lo Cenlre for Allied Heollh Sciences, Amrilo School ol Medicine,
hove received o copy ol lhe UGC Regulolions on Curbing lhe Menoce ol Rogging in
Higher Educolionol lnslilulions, 2009, (heleinoller colled lhe "Regulolions") corefully reod
ond fully undelslood lhe plovisions conloined in lhe soid Regulolions.
2) I hove, in porliculor, perused clouse 3 ol lhe Regulolions ond om owore os lo whol
conslilules rogging.
3) I hove olso, in pqrticulor, perused clouse 7 ond clouse 9.1 of lhe Regulolions ond om
fully owore of lhe penol ond odminislrolive oclion thot is lioble lo be token ogoinst me in
cose lom lound guilly of or obetling logging, oclively or Possively, or being porl ol o
conspirocy lo promole rqgging.
4) I hereby solemnly over ond underloke lhol :-
o) lwill nol indulge in ony behoviour or ocl lhol moy be consliluled os rogging under
clouse 3 of lhe Regulotions.
b) lwill not porlicipole in or obel or propogole lhrough ony ocl of commission oI omis-
sion thol moy be conslituled os rogging under clouse 3 of lhe Regulolions.
5) I hereby ollirm lhol, il lound guilty of rogging, I om lioble for punishmenl occording fo
clouse 9.1 of lhe Regulolions, wilhoul prejudice lo ony olher criminol oclion lhol moy be
loken ogoinsl me under ony penol low or ony low lor lhe lime being in force.
6) I hereby declore lhol lhove nol been expelled or deborred lrom odmission in ony
instilulion in lhe counlry on occounl ol being lound guilly of, obetling or being porl of o
conspirocy lo promole, iogging; ond furlher ollirm lhol, in cose lhe declorolion is found
lo be unlrue. I om owore lhol my odmission is lioble lo be concelled.
Declored lhis ------'-----doy ol ---------------------- monlh ol 2019 yeoI.
Signolure ol Sludenl :
Nome:
VERIFICAl10N: Verified ihol the contenis of lhis offidovil ore true lo lhe besi of my
knowledge ond no porl ol lhe offidovil is:olse ond nolhing hos been conceoled or
missioted iherein
verined。 l cenire for Alhed He● :lh Sciences,Amrilo School of Medicine′ Kochi on lhis
doy of monlh of yeor
Signolure of Sludenl:
AFFIDAVIT BY PARENT/GUARDIAN
l. Mr./Mrs./Ms.
(full nome of porenl/guordion) folher/molher/guordion ol ---- -----------
(lull nome of sludenl wilh odmission/regisholion/enlolmenl number) , hoving been od-
mitled loCenlre lor Allied Heolth Sciences, Amrilo School ol Medicine, hove
received o copy ol the UGC Regulolions on Curbing lhe Menoce ol Rogging in Higher
Educolionol lnslitulions, 2009, (hereinofler colled lhe "Regulolions"), corelully ]eod ond
fully underslood lhe provisions contoined in the soid Regulolions.
2) I hove, in porliculor, perused clouse 3 ol lhe Regulolions ond om owore os lo whol
conslilules rogging.
3) I hove olso, in porliculor, perused clouse 7 ond clouse 9.1 ol lhe Regulolions ond om
lully owore ol lhe penol ond odminislrolive oclion lhol is lioble lo be loken ogoinsl my
word in cose he/she is lound guilty of or obetling rogging, oclively or possively, or being
porl of o conspirocy lo promole rogging.
4) I hereby solemnly over ond underloke lhol : -
o) My word will nol indulge in ony behoviour or ocl lhol moy be consliluled os rogging
under clouse 3 ol lhe Regulolions.
b) My word will nol porlicipole in or obel or propogole lhrough ony ocl of commission or
omission lhol moy be consliluled os rogging under clouse 3 of lhe Regulolions.
5) I hereby oflirm lhol, il lound guilly of rogging, my word is lioble for punishmenl occord-
ing io clouse 9.1 ol the Regulolions, wilhoul prejudice lo ony olher criminol oclion lhot
moy be loken ogoinsl my word under ony pendl low or ony low ror lhe lime being in
force.
6) I heleby declore lhol my word hos nol been expelled or deborred from odmission in
ony inslilulion in lhe counlry on occounl ol being lound guilly of, obetling or being pod of
o conspirocy lo promole, rogging; ond lurther otlirm lhol, in cose lhe declorolion is lound
lo be unlrue, lhe odmission of my word is lioble lo be concelled.
Declored lhis doy ol month ol yeor 2019.
Signolure ol Porenl :
Nome:
Address:
Telephone/ Mobile No.:
VER ICATION
Verified lhol lhe conlenls of lhis ollidovit ore lrue lo lhe besl of my knowledge ond no
porl of lhe otfidovil is folse ond nolhing hos been conceoled or missloled lherein.
Verified ol Cenlre lor Allied Heolth Sciences, Amrilo School of Medicine, Kochi on lhis
doy of monlh of yeor.
Signolure of Porenl: