Specimen of affidavit to be submitted by the Transferee on Rs. 10/- 
Non Judicial Stamped Paper duly attested by the Magistrate

I _____________________________ S/o __________________________ resident of _________________ ____________________________ do hereby solemnly affirms and declare as under :- 

1. That I/We hereby agree to accept the Phone No. ___________________ with its accessories and I agree to abide by the provisions of Indian Telegraph Rules 1951, as amended from time to time and I am not defaulter of Department of Telecom. 

2. That I/We undertake to indemnify the Department of Telecommunications against any future claim or dispute regarding the transfer of telephone which may arise at a subsequent date. 

3. That I also undertake to pay alldues against the Telephone and othe accessories including any pending dues pertaining to the prior date of transfer. 

4. That I fully realise that the transfer of telephone carried with it all liablities thereof. 

5. That I am/we are willing to pay Rs __________________ as transfer fee. 

6. That I will not ask for the transfer of Telephone of five years from the date of this widow is left. 

7. That I am the only legally wedded wife of late Sh. ________ __________ _________ ______ and no other widow is left. 

8. That Late Shri _____________________________ has left/not left any WILL. 

9. That I am willing to pay Rs. __________________________ as OYT Deposit. 

Place 
Date : 

Deponent 

Verification : 
Verified that the facts stated above are true to the best of my knowledge and belief and nothing has been concealed therein. 

Place 
Date : 

Deponent