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A F F I D AV I T
(Indemnity Bond)
3. I hereby undertake that there is no case pending in any of the courts regarding title of the
premises and that I will not claim the water supply & sewerage connection sanctioned to
me as a title deed or claim it to be an evidence in support of claiming the title over the
premises, in case of title dispute arises, if any, in future
4. I hereby indemnify against the legal action against the HMWS&SB or to pay any cost or
compensation in the vent of HMWSSB being made liable to pay in respect thereof
5. I also undertake to abide by the rules & regulations relating to water supply & sewerage
in force from time to time.
6. I will pay the monthly bill amounts regularly without any default.
The contents hereby declared by me are true to the best of my knowledge and in the event
of any one of the above is proved to be incorrect or false I shall be liable for departmental and
legal actions.
Deponent
Witness:
Sl. No. Name with father/husband’s name Age Occupation Address Signature
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Read over the above contents and after admitting whereof the deponent signed this affidavit on
this the ______________________day of _____________________2017, in my presence.
NOTARY