Lost WBCHSE Higher Secondary Marksheet Affidavit & Duplicate Application

Before the Ld. Concerned Authority / Notary Public At Ghatal, Dist.- Paschim Medinipur, West Bengal AFFIDAVIT (On Non-Judicial Stamp Paper of ₹10 Non-Judicial Stamp Paper) In the matter of: Lost WBCHSE Higher Secondary Marksheet Affidavit & Duplicate Application I, [Deponent Name], [S/O / D/O / W/O] [Father / Husband Name], aged about [Age] years, by faith [Religion], by occupation [Occupation], residing at Vill.- [Village / Ward No.], P.O.- [Post Office], P.S.- [Police Station], Sub-Division- Ghatal, Dist.- Paschim Medinipur, Pin- [Pin Code], West Bengal, do hereby solemnly declare, affirm and state on oath as under:- 1. That I successfully cleared the Higher Secondary (10+2) Examination from WBCHSE in the year [Exam Year]. 2. That my original marksheet has been lost / destroyed beyond recovery due to accidental misplacement. 3. That a formal Police GDE was registered at the local police station regarding this missing document. 4. That I am swearing this affidavit for the issuance of a certified duplicate marksheet by the Concerned Authority. Verification:- I, the above-named deponent, do hereby verify and declare that the statements made in paragraphs 1 to 4 above are true and correct to the best of my personal knowledge, belief and derived from authentic records. No material facts have been suppressed, concealed or misstated herein. If any statement is subsequently found to be false or incorrect, I shall be liable to face statutory legal prosecution under the Indian Penal Code / Bharatiya Nyaya Sanhita and relevant provisions of West Bengal Council of Higher Secondary Education Regulations. Solemnly affirmed and signed on this [Date] day of [Month], [Year] at Ghatal. ___________________________ Deponent Signature / LTI Identified by me and signed in my presence: ___________________________ Advocate, Ghatal Dewani Court Dist.- Paschim Medinipur, West Bengal