Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697802961003.pdf (India)
(Specimen of affidavit to be submitted by the retiree at the time of retirement) AFFIDAVIT Affidavit of Shri/Smt.

___________________________________________ I, _____________________________, the above named deponent do hereby solemnly affirm and declare as under:- That I have not obtained any long term advances/loans during my entire period of Government service.

OR That I have taken no other long term during the entire period of my Government service:- advance except as indicated below Sr. No.
Detail/Amount of advance drawn (i.e.HBA, Conveyance advance etc.

Number and Date of Sanction.

of Amount of Principal/ Interest recovered upto the date of retirment.

Amount Principal/ Interest recoverable after retirement.

1.

2.

3.

4.

That the above long term advance(s) drawn by me has/have been adjusted fully in the audit books and clearance letter(s) obtained from the audit office is/are enclosed.
That I undertake to refund to the Government any amount, which may be found due from me after release of my P.P.O.

and D.C.R.G.

VERIFICATION DEPONENT I, ________________________________ the above named deponent do hereby solemnly affirm and declare that whatever is stated above is true and correct to the best of my knowledge and belief and that no part of it is false and nothing has been concealed.

Verified at _______________ on _________ day of __________ 20 .

DEPONENT