Format of affidavit to be made on a non-judicial stamp paper of Rs.
50/- (Rupees Fifty Only) before
Executive Magistrate or a Metropolitan Magistrate by the candidate, who has completed 18 years of
age and has been allotted a seat in B.D.S. under Jain Minority Category at Sumandeep Vidyapeeth,
Vadodara, Gujarat.)
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Affidavit
I, ______________________________________________________________________________,
an Indian Inhabitant, aged________________ in years, Aadhar No. __________________________
Son / Daughter of Mr . _________________________ & Mrs._______________________________
residing at ______________________________________________________________________
_______________________________________________________________________________
I do hereby solemnly affirm and say:
1. That, I am residing at above mentioned address.
2. That, I belong to Jain religion by birth.
3. That, I belong to Jain Minority community which is included in notified minority communities
under Section 2(C) of the National Commission for Minorities Act, 1992, by the Government of
India.
4. That in support of my statement, I am enclosing copies of following documents with the present
affidavit
A. Jain Minority Certificate issued by State Government or any statutory authority
B. Jain Minority Certificate issued by local religious Jain Sangh
C. School leaving certificate of self-mentioning religion as Jain
D. School leaving certificate of my Father/ Mother mentioning religion as Jain
E. Any other: ………………………………………………………………………
5. That I have opted for admission under Jain Minority Category in B.D.S. during the Academic
Year 2020-21 at Sumandeep Vidyapeeth, an Institution Deemed to be University, At &Post
Piparia, Ta. Waghodia, District Vadodara, Gujarat, being fully aware that by doing so I abide by
all the terms and conditions defined therein.
6. That, I am fully aware of the fact that, as I am taking admission under Jain Minority category, as
per the regulations of the Sumandeep Vidyapeeth, I will have to submit
a) Undertaking for Future Fees &
b) Service Bond of one year of posting at a place which will be purely at the discretion of the
Sumandeep Vidyapeeth.
In that case, I shall have to follow the other terms and conditions of the “Undertaking” and
1
“Service bond” including the penalty clause.
7. I fully understand that after accepting admission in Jain category, change in category of
admission shall not be permitted, as that undermines merit and shall attract the same penalty as
breach of conditions of the “Service Bond" as stated in the bond.
8. That, I am fully aware and agree to the fact that my admission will be cancelled, if any time in
future, it is found that false information has been submitted or wrongly represented by me or the
documents submitted by me at the time of admission were found to be fraudulent / forged or I
have made fraudulent claim of belonging to Jain Minority Community.
9. That, I am fully aware and agree to the fact that due to any reason, what so ever, if I discontinue
the course after getting the admission or being made to leave the course on account of
indiscipline or misconduct or in the event of cancellation of my admission due to circumstances
mentioned in clause (8) above, I shall be liable to the conditions mentioned in “Undertaking for
Future Fees” submitted by me at the time of admission.
I understand and agree that Sumandeep Vidyapeeth can initiate any appropriate legal procedure
for the recovery of entire outstanding amount against me.
Whatever stated hereinabove is true and genuine to the best of my knowledge and affirmed
without undue influence, by force or coercion.
Solemnly affirmed at__________( Name of Place ) this Date_____ (day of) Month_____
2020.
Signature of Candidate:
Name of Candidate:
2
Format of Undertaking for Payment of Future Fees to be made on a stamp paper of Rs.
300/- (Rupees Three Hundred Only) before Notary or Executive Magistrate or a
Metropolitan Magistrate by the Candidate, who is allotted in Jain Minority Category for
B.D.S. at Sumandeep Vidyapeeth, an Institution Deemed to be University)
UNDERTAKING
This undertaking is given by Mr. / Ms. / Mrs. ______________________________________
Aged __________ in years, Aadhar No. ______________________________________,
Son / Daughter of Mr. ______________________ & Mrs. ___________________________
residing at ________________________________________________________________
_________________________________________________________________________.
I do solemnly affirm and state as under:
1. I say that I have been provisionally selected for admission to BDS Course under Jain
Minority Category for the A.Y.2020-21
2. I say that I have not joined / doing any course at any other medical institute/ college in India
/abroad.
3. That at present, I have not joined any government / semi-government / Private service.
4. I undertake to pay the Fees of Rs 3,37,500/- Jain Minority category for First BDS at the
time of admission to the Sumandeep Vidyapeeth, an Institution Deemed to be University.
5. I hereby undertake to pay fees regularly within the time notified by the Sumandeep
Vidyapeeth. I understand and agree that I will be liable to pay the fine as per regulations of
Sumandeep Vidyapeeth in the event of failing to pay the fees by due date.
6. I undertake to secure the payment of the fees for future period of course by providing an
undertaking and unconditional bank guarantee in favor of "Sumandeep Vidyapeeth Deemed
to be University” for the amount payable at each stage of program. Thereby, I submit Bank
guarantee drawn on _____________________ Bank bearing No. ___________________
dated ___________.
OR
I undertake to secure the payment of the fees for future period of course by providing an
undertaking and account payee undated cheques for the amount payable at each stage of
program, to be drawn in the name of “Sumandeep Vidyapeeth Deemed to be University”.
Thereby, I submit account payee cheques with details below:
Sr. Cheque Name of A/C
Bank/ Branch Name Amount Fee for Year
No. No. Holder
1 Rs 3,37,500 2nd BDS
2 Rs 3,37,500 3rd BDS
Rs 3,37,500 4th BDS
3
3
7. That I am fully aware and agree to the fact that my admission will be cancelled if any time in
future it is found that false information has been submitted or wrongly represented by me or
the documents submitted by me at the time of admission were found to be fraudulent /
forged or on account of indiscipline or misconduct on my part amounting to cancellation of
admission as per the regulations of Sumandeep Vidyapeeth.
8. I hereby agree & undertake to pay the total fees of the entire course without any demur, in
the event of cancellation of my admission due to circumstances mentioned in clause (7)
above or for any reason whatsoever or in the event of failing to pay fees in-time or leaving
the course anytime after second round of counseling, as the seat remains vacant thereafter
as per Medical Counseling Committee (MCC) regulations. In that event, Sumandeep
Vidyapeeth has all the rights to recover the payment of the fees for balance years by
redeeming unconditional bank guarantee or by encashing undated cheques submitted by
me or my parent/ guardian, in favor of Sumandeep Vidyapeeth Deemed to be University
payable for the entire period of the remaining course tenure, totally amounting to Rs.
10,12,500/- for fees of students admitted in B.D.S program under Jain Minority category. I
understand and agree that Sumandeep Vidyapeeth can initiate any appropriate legal
procedure for the recovery of entire outstanding amount againstme.
9. I undertake to deposit my Original Documents with Sumandeep Vidyapeeth for Verification.
10. That I will be entitled for approaching/applying to the external sources providing scholarship,
with prior intimation to the Institution and will be entirely responsible to commitments made
to the scholarship authorities and Suamandeep Vidyapeeth shall not be responsible. I am
fully aware and agree that Sumandeep Vidyapeeth or any of its constituent institutes are not
accountable for delay in sanction / non-sanction of scholarship by any external sources
(Government/Non-Government).
11. I say that I am aware that the repeater (failure) fees will be charged as per the rules and
regulations of the Sumandeep Vidyapeeth, an Institution Deemed to be University.
12. I say that I am aware about the code of conduct of the Institution and agree that I shall be
liable to disciplinary actions, for any breach in code of conduct, as deemed appropriate by
the Institution.
13. Provided always and it is hereby agreed and declared that the decision of the Sumandeep
Vidyapeeth as to whether I have or have not performed and observed any of the obligations
and conditions herein recited shall be final and binding.
Executed and affirm upon my own will and without undue influence or force or coercion.
Date:
Place: Vadodara
Signature of Student
Signature of Parent / Guardian
Before me
4
Format of Undertaking for Payment of Future Fees to be made on a stamp paper of Rs.
300/- (Rupees Three Hundred Only) before Notary or Executive Magistrate or a
Metropolitan Magistrate by the Candidate, who is allotted in Management Category for
B.D.S. at Sumandeep Vidyapeeth, an Institution Deemed to be University)
UNDERTAKING
This undertaking is given by Mr. / Ms. / Mrs. ______________________________________
Aged __________ in years, Aadhar No. ______________________________________,
Son / Daughter of Mr. ______________________ & Mrs. ___________________________
residing at ________________________________________________________________
_________________________________________________________________________.
I do solemnly affirm and state as under:
14. I say that I have been provisionally selected for admission to BDS Course under
Management Category for the A.Y.2020-21
15. I say that I have not joined / doing any course at any other medical institute/ college in India
/abroad.
16. That at present, I have not joined any government / semi-government / Private service.
17. I undertake to pay the Fees of Rs 3,75,000/- Management category for First BDS at the
time of admission to the Sumandeep Vidyapeeth, an Institution Deemed to be University.
18. I hereby undertake to pay fees regularly within the time notified by the Sumandeep
Vidyapeeth. I understand and agree that I will be liable to pay the fine as per regulations of
Sumandeep Vidyapeeth in the event of failing to pay the fees by due date.
19. I undertake to secure the payment of the fees for future period of course by providing an
undertaking and unconditional bank guarantee in favor of "Sumandeep Vidyapeeth Deemed
to be University” for the amount payable at each stage of program. Thereby, I submit Bank
guarantee drawn on _____________________ Bank bearing No. ___________________
dated ___________.
OR
I undertake to secure the payment of the fees for future period of course by providing an
undertaking and account payee undated cheques for the amount payable at each stage of
program, to be drawn in the name of “Sumandeep Vidyapeeth Deemed to be University”.
Thereby, I submit account payee cheques with details below:
Sr. Cheque Name of A/C
Bank/ Branch Name Amount Fee for Year
No. No. Holder
1 Rs 3,75,000/- 2nd BDS
2 Rs 3,75,000/- 3rd BDS
Rs 3,75,000/- 4th BDS
3
20. That I am fully aware and agree to the fact that my admission will be cancelled if any time in
5
future it is found that false information has been submitted or wrongly represented by me or
the documents submitted by me at the time of admission were found to be fraudulent /
forged or on account of indiscipline or misconduct on my part amounting to cancellation of
admission as per the regulations of Sumandeep Vidyapeeth.
21. I hereby agree & undertake to pay the total fees of the entire course without any demur, in
the event of cancellation of my admission due to circumstances mentioned in clause (7)
above or for any reason whatsoever or in the event of failing to pay fees in-time or leaving
the course anytime after second round of counseling, as the seat remains vacant thereafter
as per Medical Counseling Committee (MCC) regulations. In that event, Sumandeep
Vidyapeeth has all the rights to recover the payment of the fees for balance years by
redeeming unconditional bank guarantee or by encashing undated cheques submitted by
me or my parent/ guardian, in favor of Sumandeep Vidyapeeth Deemed to be University
payable for the entire period of the remaining course tenure, totally amounting to Rs.
11,25,000/- for fees of students admitted in B.D.S. program under Management category. I
understand and agree that Sumandeep Vidyapeeth can initiate any appropriate legal
procedure for the recovery of entire outstanding amount against me.
22. I undertake to deposit my Original Documents with Sumandeep Vidyapeeth for Verification.
23. That I will be entitled for approaching/applying to the external sources providing scholarship,
with prior intimation to the Institution and will be entirely responsible to commitments made
to the scholarship authorities and Suamandeep Vidyapeeth shall not be responsible. I am
fully aware and agree that Sumandeep Vidyapeeth or any of its constituent institutes are not
accountable for delay in sanction / non-sanction of scholarship by any external sources
(Government/Non-Government).
24. I say that I am aware that the repeater (failure) fees will be charged as per the rules and
regulations of the Sumandeep Vidyapeeth, an Institution Deemed to be University.
25. I say that I am aware about the code of conduct of the Institution and agree that I shall be
liable to disciplinary actions, for any breach in code of conduct, as deemed appropriate by
the Institution.
26. Provided always and it is hereby agreed and declared that the decision of the Sumandeep
Vidyapeeth as to whether I have or have not performed and observed any of the obligations
and conditions herein recited shall be final and binding.
Executed and affirm upon my own will and without undue influence or force or coercion.
Date:
Place: Vadodara
Sign of Students
Signature of Parent / Guardian
Before me
6
(Format of Undertaking for Payment of Future Fees to be made on a stamp paper of Rs. 300/-
(Rupees Three Hundred Only) before Notary or Executive Magistrate or a Metropolitan Magistrate
by the Candidate, who is allotted in NRI Category for B.D.S at Sumandeep Vidyapeeth, an Institution
Deemed to be University)
UNDERTAKING
This undertaking is given by Mr. / Ms. / Mrs. ______________________________________
Aged __________ in years, Aadhar No. ______________________________________,
Son / Daughter of Mr. ______________________ & Mrs. ___________________________
residing at ________________________________________________________________
_________________________________________________________________________.
I do solemnly affirm and state as under:
27. I say that I have been provisionally selected for admission to BDS Course under NRI
Category for the A.Y.2020-21
28. I say that I have not joined / doing any course at any other medical institute/ college in India
/abroad.
29. That at present, I have not joined any government / semi-government / Private service.
30. I undertake to pay the Fees of USD 9000 of NRI category for First BDS at the time of
admission to the Sumandeep Vidyapeeth, an Institution Deemed to be University.
31. I hereby undertake to pay fees regularly within the time notified by the Sumandeep
Vidyapeeth. I understand and agree that I will be liable to pay the fine as per regulations of
Sumandeep Vidyapeeth in the event of failing to pay the fees by due date.
32. I undertake to secure the payment of the fees for future period of course by providing an
undertaking and unconditional bank guarantee in favor of "Sumandeep Vidyapeeth Deemed
to be University” for the amount payable at each stage of program. Thereby, I submit Bank
guarantee drawn on _____________________ Bank bearing No. ___________________
dated ___________.
OR
I undertake to secure the payment of the fees for future period of course by providing an
undertaking and account payee undated cheques for the amount payable at each stage of
program, to be drawn in the name of “Sumandeep Vidyapeeth Deemed to be University”.
Thereby, I submit account payee cheques with details below:
Sr. Cheque Name of A/C
Bank/ Branch Name Amount Fee for Year
No. No. Holder
1 USD 9000 2nd BDS
2 USD 9000 3rd BDS
USD 9000 4th BDS
3
33. That I am fully aware and agree to the fact that my admission will be cancelled if any time in
7
future it is found that false information has been submitted or wrongly represented by me or
the documents submitted by me at the time of admission were found to be fraudulent /
forged or on account of indiscipline or misconduct on my part amounting to cancellation of
admission as per the regulations of Sumandeep Vidyapeeth.
34. I hereby agree & undertake to pay the total fees of the entire course without any demur, in
the event of cancellation of my admission due to circumstances mentioned in clause (7)
above or for any reason whatsoever or in the event of failing to pay fees in-time or leaving
the course anytime after second round of counseling, as the seat remains vacant thereafter
as per Medical Counseling Committee (MCC) regulations. In that event, Sumandeep
Vidyapeeth has all the rights to recover the payment of the fees for balance years by
redeeming unconditional bank guarantee or by encashing undated cheques submitted by
me or my parent/ guardian, in favor of Sumandeep Vidyapeeth Deemed to be University
payable for the entire period of the remaining course tenure, totally amounting to USD
27000 (or amount payable in INR equivalent to USD 27000 as per prevailing rate of
Currency conversion) for fees of students admitted in B.D.S. program under NRI category.
I understand and agree that Sumandeep Vidyapeeth can initiate any appropriate legal
procedure for the recovery of entire outstanding amount againstme.
35. I undertake to deposit my Original Documents with Sumandeep Vidyapeeth for Verification.
36. That I will be entitled for approaching/applying to the external sources providing scholarship,
with prior intimation to the Institution and will be entirely responsible to commitments made
to the scholarship authorities and Suamandeep Vidyapeeth shall not be responsible. I am
fully aware and agree that Sumandeep Vidyapeeth or any of its constituent institutes are not
accountable for delay in sanction / non-sanction of scholarship by any external sources
(Government/Non-Government).
37. I say that I am aware that the repeater (failure) fees will be charged as per the rules and
regulations of the Sumandeep Vidyapeeth, an Institution Deemed to be University.
38. I say that I am aware about the code of conduct of the Institution and agree that I shall be
liable to disciplinary actions, for any breach in code of conduct, as deemed appropriate by
the Institution.
39. Provided always and it is hereby agreed and declared that the decision of the Sumandeep
Vidyapeeth as to whether I have or have not performed and observed any of the obligations
and conditions herein recited shall be final and binding.
Executed and affirm upon my own will and without undue influence or force or coercion.
Date:
Place: Vadodara
Sign of Students
Signature of Parent / Guardian
Before me
8
