SELF ATTESTED DOCUMENT

I,____________________AGED________________

RESIDING AT____________________________________WILLFULLY APPROACHED MR.IYER AND OPTED FOR THESCHEME__________________________________________________________________WITHRS.___________________________.AND NOT UNDER ANY COERCION OR ANY INFLUENCE.

I KNOW THAT PREMATURE CLOSURE BEFORE_____________________________YEARS IS NOT POSSIBLE AT ALL AT ANY SITUATION AND THIS CASE IS PURELY OF CIVILNATURE AND ONLY FOR MY BENEFIT I AM ENTERING THIS _______________________________SCHEME AND NOT UNDER ANY INFLUENCE AT ANY SORT

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