AFFIDAVIT FOR INSTALL NEW TOWERS OR POLES OR ANTENNA
Before The Ld. Notary Public at …………….(Name of place)
I, _________________, W/S/D of ______________, _____________(Name of occupation) of __________________(Name of company) having its registered office at _________________________________________(Address with pin code, P.O, P.S, District and State) do hereby solemnly declare and affirm as follows:-
1. That we shall follow and comply the guidelines for erecting Towers/Poles/Antenna issued by Department of Environment, Govt. of ____________(Name of state), _______________________( Address with pin code) vide their Memo No. _______________________.
2. That we shall install Towers/Poles/Antenna ______ meter away from nearby building and it shall not face directly with the building and lower end of antenna shall be _____ meter above the ground or roof.
That the statements made above are true to my knowledge and belief and sign this affidavit on this the ______ day of ____(month) _________(year) at _______(Name of place).
D E C L A R A N T
Identified by me
Advocate / ______________(Name of place)