AFFIDAVIT OF PROPRIETOR / PARTNER (S) / DIRECTOR (S) FOR WHOLESALE TRADE
Before the NOTARY PUBLIC AT……………..(Name of place)
I/WE, (i) Sri / Smt. ___________________________________ Son of / Daughter of / wife of ________________________ aged about ____________ years, by occupation ____________, presently residing at *[and (ii)] same details of other applicants (deponents if any)] ____________________________________________________ do hereby solemnly affirm and declare as follows: -
- THAT, I/we am/are a citizen of India by birth / by registration at ____________________________.
- That, I /We am /are not in the employment under Government or any Government institution or Government undertaking organization as on date.
- THAT, I/we am/are the Proprietor / Proprietress / Partner / Director of M/s _____________________________ having its address at Holding/Dag No. ____________, Ward No. / Kh. No. _____, J.L. No. ______, Mouza _____, Municipality / Corporation, Vill ____ , P.O. __________, P.S. ________, District __________, Pin Code ________.
- THAT, I / we intend to engage Sri /Smt ________________________________________ on whole time basis as a Competent Person in terms of provisions of Rule 64(2)(ii) of the Drugs & Cosmetics Rules, 1945 in my/our said firm M/s _________________________ having its address at _______________ with effect from________, to supervise the sale, purchase, distribution, storage of Drugs from my / our proposed above mentioned premises.
- THAT, Sri /Smt. __________________________ is not engaged anywhere else as a Competent Person or in any capacity in other Firm except my / our Firm and if it is proved to the contrary or false my/our application for grant of Wholesale Drug license is liable to the consequence including rejection and cancellation.
- I /We further state that to maintain cleanliness and hygenicity, no business / trade / profession other than the trade of medicines / drugs / by me / us or by me / our agent or any other person will be conducted within the licensed premises or in its adjoining space having inter connections with the licensed premises.
- That the proposed premises is presently not having any valid Drug License as far as my/our knowledge is/are concerned. That the firm will comply with the rules of CCE (Chief Controller of explosives).
- That I/We know that knowingly furnishing false information to a public servant is a criminal offence of the Indian penal code (IPC) and I/We may be prosecuted by the appropriate authority before and even after issuance of license for such act and my our application for grant of licenses and my /our licenses if already issued, would also be liable to consequences including rejection and / or cancellation.
That all the statements made above are correct & true to the best of my knowledge and belief.
Identified by me and signed in my presence
ADVOCATE/_______________Name of place