info@aliah.ac.in        

Department of  NURSING



Prospectus

Aliah University

DEPARMENT OF NURSING

Message from the desk of HoD, Department of Nursing, Aliah University.

Aliah University started its glorious journey from the 2008-09 academic session with great potential and immense opportunities. It is hoped that this university harmonizing tradition and modernity will immerge as a unique institution of higher studies and research.

As per Aliah University Act 2007, Section 3(3), it has been conferred the status of a minority educational institution. It is hoped that along with the people of any race, creed, caste or class, this university will play a crucial and leading role in the advancement of higher education for socially and educationally backward classes belonging to the Minorities.

Department of Nursing of Aliah University is a very new initiative to encourage female education, to help students to acquire basic and sound technical and scientific knowledge and skills in nursing profession. The Department of Nursing established in the year 2016 with its first batch of B.Sc Nursing course with 60 annual intake.

Under Aliah University, Department of Nursing is affiliated with West Bengal Nursing Council and Indian Nursing Council.

It is always our core objective to impart quality knowledge and training to our students to prepare them a good professional as well as citizen of this country and to develop awareness and carry forward their social responsibilities.

With Best Wishes,

Prof. Nargis Ahamed

HoD, Department of Nursing

Aliah University.

Contact : 7604092636

Address : Department of Nursing,

E-mail : nmadhu_31@rediffmail.com

 

 

 

 

Aliah University is an autonomous institution under the Department of Minority Affairs and Madrasah Education, Govt. of West Bengal.

 

KEY FEATURES OF DEPARTMENT OF NURSING, ALIAH UNIVERSITY

• Recognized by state & Indian Nursing Council ; approved by Government of West Bengal.

• Focuses on nursing excellence i.e. clinical expertise, quality management & professionalism

• Equipped with modern educational system.

• Values personal grooming

• Competent & experienced nursing faculty members

• Excellent facilities for hostel, mess etc.

• Encourages students to shine in extracurricular activities

• Provides opportunities to engage in community services

• Provides opportunities to grow in diverse culture of the campus

 

PHILOSOPHY 

The faculty members of Department of Nursing believe in -

  • contributing to the creation of innovation oriented society and develop new solutions that elevate the quality of life by utilizing up-to-date knowledge
  • disseminating professional knowledge, skill & non-judgemental holistic care towards the patient in a resourceful way as per global standards
  • fostering all round development of students, professionally & personally with academic & extracurricular events
  • acting as a role model & mentor to inculcate confidence & leadership qualities among students
  • ongoing feedback & evaluation process which will contribute to the continuous development of student’s performance and help them in growing into effective professionals

 

VISION

The Department of Nursing strives for outstanding educational outcomes exemplified by graduates who will be recognized for excellence, leadership and compassionate care.

 

MISSION

  • to promote professionalism by quality and value driven education with a global outlook
  • to make learning an exciting experience that inspires learners to reach clinical practices with their full potential as lifelong learners
  • to train young professionals for leadership to respond to the health care needs of the public
  • to foster synergy and integration between research, education and practice by promoting interdisciplinary collaboration and partnership
  • to provide an education foundation to promote self reliance, cultural competence, ethical sensitivity, leadership and lifelong learning in nursing profession
  • to attract and retain the best professional talents through continuous professional and personal developments, reward honour for excellence.

ACADEMIC CONTROL : Aliah University

ADMINISTRATIVE CONTROL : MA & ME DEPT. GOVT. OF WEST BENGAL

 

MEDIUM OF INSTRUCTION

The Medium of instruction and Examination shall be in English.

NUMBER OF SEATS

BSc Nursing : 60

COURSE : B.SC.NURSING

Duration: 4 years (Only for female candidates)

SCOPE FOR THE GRADUATES

• There is a vast scope of nursing all over India and in the world today. The demand for Indian

   nurses in developed countries like USA, UK and others is increasing tremendously.

• Graduates can work in Government / Non-government Organizations, Educational Institutions,

   Community Setting, Army Nursing, Navy Nursing, Railway Nursing, School Health Nursing etc.

• Graduates can be - Nurse Clinician, Nurse Educator, Nurse Administrator or Nurse Researcher

• They can serve in the capacity of a staff nurse, sister and/or a supervisor in the branches of

  Medical- Surgical Nursing, O.T. Nursing, Critical Care Nursing, Cardiothoracic Nursing,

  Neurological Nursing, Child Health Nursing, Mental Health Nursing and in Gynae, Maternity

  and Obstetrical Nursing in hospital setup.

 • There is scope of higher studies i.e. Masters, M.Phil and Doctorate in Nursing

ELIGIBILITY CRITERIA FOR ADMISSION IN B.SC NURSING PROGRAMME

  1. Minimum education: Candidate must have passed in 10+2 examination with Physics, Chemistry, Biology & English individually ( to pass theory & practical separately where applicable) and must have obtained a minimum of 45% marks & pass in each subject from recognized board under WBCHSE/WBBME/CISCE/CBSE/ NIOS or other equivalent Boards.
  2. Candidates appearing in the 10+2 examination are also eligible to appear in Aliah University Admission Test. However their admission will be cancelled if they fail to secure minimum prescribed marks/grade in final examination or fail to produce final mark sheet/grade card at the time of admission.
  3. Candidates should be a domicile of West Bengal for last 10 years. Supporting documents must be produced.
  4. Only female candidates are eligible.
  5. The age of the candidate should be minimum 17 years & maximum 27 years on the 31"  December of the year of admission.
  6. Candidate shall be medically fit. All qualified candidates may be required to submit a physical fitness certificate from a registered medical practitioner in the prescribed format that will be made available to them at an appropriate time. They will be admitted only if they are physically fit for pursuing the course of study.

 

ONLINE APPLICATION & PATTERN OF AUAT :

  1. Candidate wish to appear AUAT must apply through online mode of application process.
  2. After submitting the online application successfully, a confirmation sheet/application pdf bearing the full application summary with the photo & signature of the candidate will be generated by the system.
  3. Candidates have to print the confirmation sheet and send it with the photocopies of all the testimonials (Marksheets, age proof, proof of caste or PC if applicable) to  the university address
  4. Any delay in online form fill up by the candidate will not be considered as a valid reason for the late submission of the confirmation sheet/application pdf after the deadline. The university will not accept responsibility for any postal delay or irregularity or loss during postal transit.
  5. Candidate have to send the ‘Confirmation sheet’ to the University office by speed post/Registered post in the address given below :

          The Chairman, AUAT, Aliah University

          Newtown Campus, Action Area – II, Kolkata – 700156.

  1. The paper of AUAT examination is 2 hours duration ( 100 marks in total). Part A: 20 marks on English & Islamic Studies (in the ratio of approximately 1:1) & Part B : 80 marks will comprise of Biology, Chemistry and Physics (in the ratio of 2:1:1).
  2. Questions in all papers will be objective type in multiple choice questions (MCQ) format, which are to be answered on a specially designed machine gradable sheet (ORS-Optical Response Sheet) using black/blue ball point pen only.
  3. Question paper will be in English language.
  4. Question paper will not be allowed to take out from the examination hall.

SYLLABI :

Part A : Basic knowledge of vocabularies, grammar and comprehension at 10+2 level

Part B : As per syllabus of JENPARH/JENPAUH, West Bengal.

APPLICATION FEE :

Rs. 300

POSSIBLE EXAMINATION VENUE :

Aliah University, New Town Campus, Kolkata.

ADMIT CARD :

Candidates have to download and print their admit cards from the university website by logging in by putting their application form number (application ID) and date of birth (password). No admit card will be sent to the respective candidates.

The admit card will bear the name, photograph, signature, address and category of the candidate along with name and address of the examination center. The candidate should carefully examine the admit card received by her for all the entries made therein. In case of any discrepancy, the candidate should inform the AUAT office immediately.

SELECTION PROCESS :

  • A list of successful candidates appearing AUAT for B.Sc Nursing program will be displayed separately on the university website: www.aliah.ac.in on the basis of scores in the written test. Separate list of successful candidates will also be prepared for reserved (SC/ST/OBC) & physically challenged (PC) candidates.
  • Selection will be based on as per state Govt. reservation policy.
  • A rank card, containing all relevant information regarding counseling will be provided to all successful candidates at the time of publication of result of AUAT.
  • The candidate will be directed to visit the AUAT office in person to complete the verification and admission process within the time period (to be specified in the portal).
  • If a candidate fails to complete the admission process within the stipulated time period, then the seats will be offered for the candidate next in rank.
  • The allotment offered by AUAT is only a provisional allotment; the candidature of the candidate will be automatically cancelled if she does not satisfy the eligibility criteria.
  • Important instructions to the candidates –
  • After the merit list is published in the website, candidates can download their final allotment card by logging their application ID and password. Bring final allotment card at the time of admission, without this, the candidature may be cancelled.
  • Candidate should download the APPLICATION/ADMISSION FORM from the admission section of the university website and bring filled in admission form with passport size photo pasted in it at the time of admission.
  • They should bring original mark sheets of secondary and higher secondary level and 10+2 admit card along with self attested photocopies of the same; date of birth proof (Secondary Admit Card or Birth Certificate issued by the competent authority).
  •  Candidates and their parents will be required to give an undertaking regarding antiragging in the prescribed form in a non-judicial Rs. 10 stamp paper. They can download the form (prescribed format) from the admission section of the university website and should bring the same at the time of admission.

DOCUMENTS REQUIRED FOR ADMISSION :

The following documents in original & two sets of attested photocopies are required at the time of admission:

  1. Final Allotment Card
  2. Filled in Admission Form with passport size photo attached
  3. Anti-ragging undertaking of parent and candidate both in non-judicial Rs. 10 stamp paper
  4. All original Mark sheets of class X & XII with self attested photo copies
  5. Admit card of 10+2 level
  6. Proof of age/date of birth (10th standard certificate/birth certificate)
  7. PC certificate in original (where applicable)
  8. Migration certificate (if previously studied in any another university)
  9.  Transfer certificate
  10.  Character certificate
  11.  Residential certificate
  12.  Two copies of recent passport size photograph

 

NOTE

Only female candidates are eligible for admission. Staying in hostel is mandatory as per Indian Nursing Council.

All admissions are subject to verification of facts from the original certificates/documentations of the candidates. If an applicant is found ineligible at a later date even after admission to a program, her admission will be cancelled. The decision of the authority regarding the eligibility of any applicant shall be final.

The main purpose of asking the qualified candidates to appear in person is to verify their identity and original documents to complete the admission process. Hence the candidates must bring their admit card and other above stated documents

IMPORTANT DATES

B.Sc. Nursing

  • Online application :
  • Entrance test : As per schedule by AUAT

• Admission: As per schedule by AUAT

• Classes to commence: 1st week of October

ADMISSIONPROCEDURE

BSc.Nursing

• Eligible candidate has to appear for Aliah University  entrance examination

  • Admissions will be done on the basis of qualifying in the entrance examination.

• The physical presence of the candidate during admission is mandatory.

FEE STRUCTURE & MODE OF PAYMENT: (as provided by finance department and subjected to change from time to time)

 

Admission Fee (one time)                                                                :      Rs.   300/-

Caution deposit (one time, refundable)                                           :      Rs.   1000/-

Students’ Activities and other fee (Annual)                                    :      Rs.   300/-

Tuition/Course Fee (per semester), UG                                           :      Rs.   6000/-

Examination Fee (per semester)                                                       :      Rs.   500/-

Hostel Caution deposit (one time at admission; refundable)           :     Rs.   1500 /-

Hostel maintenance charge                                                  :     Rs.  500 /-

(payable in the month of July every year with seat rent

& mess charges or entering in the hostel whichever is earlier) 

Hostel seat rent (Payable every month by 5th day of the month)     :     Rs.   300 /-

Hostel charge (Payable every month by 5th day of the month)        :     Rs.   1200 /-

FACILITIES IN THE CAMPUS:

visit website:www.aliac.ac.in

 

ADDRESS FOR CORRESPONDENCE FOR ALL OTHER QUERIES:

HoD, Department of Nursing, Aliah University, 17, Gorachand Road, Kolkata – 700014.

Email : nargis.a@aliah.ac.in

Phone : 7604092636/9831786967

 

COUNSELLING PROCEDURE

The list of candidates eligible to attend the counseling, counseling schedule, venue and other relevant details will be made available on website www.aliah.ac.in.

Physical presence of the candidate at the counseling is mandatory. If a candidate is prevented by unavoidable circumstances from being physically present for the counseling, she may authorize another individual to represent her at the counseling. This representative must carry the authorization letter and must bring all documents and admission fees.

 

WAITING LIST

When all the seats in a given course are filled, candidates may choose to be waitlisted. Candidates will be waitlisted as per their rank order in the entrance examination.

 

DOCUMENTS

During counseling, candidates are required to produce the original and one sets of self attested

photocopies of documents.

 SECTION - 9

Following Original Documents along with the self attested copy of each document are to be

produced at the time of Counseling for verification by the institute.

• Admit card.

• Date of birth / Class X Pass Certificate

• Marks sheet of 10th pass exam

• Marks sheet of 10+2 pass exam.

• Conduct and character certificate to be obtained on the school/college letter head/pad. No other

  certificate in lieu of this will be accepted.

• Transfer certificate or school/college leaving certificate issued by the school/college. No other    

  certificate in lieu of this will be accepted.

• Migration certificate from previous University/Board.

• Four recent and identical passport size photographs.

• Anti-Ragging Declaration forms (given at Appendix I and II) duly affirmed in front of an

           Oath Commissioner.

  • Medical fitness certificate in the prescribed format along with supporting document

The self attested copy of each document mentioned above will be retained along with the following original documents.

(i) Transfer Certificate or school /college leaving certificate issued by the school/college

(ii) Migration Certificate from previous University / Board.

 

 In case of any suspicion over the authenticity or genuineness of the testimonials, the reference

may be made to the university or the Board which issues certificates to the student and the

admission be subjected to the authentication.

SEC

DISCIPLINE

The objective of department of nursing is not only to impart education but also to build up the character of the students and transform them into better human beings. The students are, therefore, expected to observe proper discipline in their conduct during the entire period they spend with the university.

Regulations are designed to ensure that the conduct of students and their discipline are up to

required standards.

 

Acts of Indiscipline: The following are regarded as acts of indiscipline:

• Failure to attend classes on regular basis

• Any act, which results in the damage or destruction of university/department property

• Ragging

• Physical assault on students and teachers/staff

• Any conduct inconsistent with the status of a student, like smoking and drinking. After the  

  enquiry, penalties ranging from fines, warnings, to expulsion from the institute can be awarded as  per the Institute regulations.

ANTIRAGGING MEASURES

The Hon'ble Supreme Court has directed that ragging be banned from all educational institutions. Ragging has been made a cognizable offence and it attracts a punishment of rigorous imprisonment of up to three years and a fine of ` 25,000/-. Ragging has been defined as: “Any act causing, inducing, compelling or forcing a student, whether by way of a practical joke or otherwise, to do any act which detracts from human dignity or violates his person or exposes him to ridicule or forbears from doing any lawful act, by intimidating, wrongfully restraining, wrongfully confining, or injuring him or by using criminal force to him or by holding out to him any threat of such intimidation, wrongful restraint, wrongful confinement, injury or the use of criminal force”.

In Aliah University, there has always been an attempt to foster a strong vibrant and warm relationship amongst all students. Ragging may invite harsh punishment that may take any of the following forms depending upon the severity of offence:-

• Suspension from classes/hostels

• Debarring from appearing in examinations

• Rustication from the college for a period up to two years

• Expulsion from the college

• Fine up to 25,000/- by a court of law. Every student admitted to Department of Nursing, Aliah University and his/ her parents/ guardians are required to sign an undertaking (Annexure I & II duly approved by the Oath Commissioner) that the student will desist from indulging in ragging.

 

ATTENDANCE

Students are required to attend a minimum of 80% of the total classes and clinical held in each subject before appearing the university examination. A candidate who does not satisfy the above requirement of attendance shall not be permitted to appear for the entire university examination. He/she shall have to satisfy the attendance requirement.

HOSTEL

As per INC the course is fully residential thus stay in the hostel is encouraged to meet the requirements of the course both academic and clinical. During the stay in the hostel, the student will strictly adhere to the Hostel Rules.

Leave rule : night pass is allowed only in one weekend in a month.

MESS

 All the students of the hostel shall be required to join the mess. Booklet on rules regarding Hostel and Mess is available at the office.

TELEPHONE CALLS: The department of Nursing does not entertain direct telephone calls to the students during working hours. Any message should be passed on through the Principal/Office. Students are not allowed to use mobile phones in the class

VACATION: Vacations are planned according to the Aliah University holiday calendar. If the students are unable to return on time due to illness, the class coordinator/HoD should be intimated immediately by telephone/e-mail followed by a written explanation. On return, they should submit a medical certificate issued by a registered medical practitioner stating full particulars of their illness and treatment. Normally, no other leave will be granted except the planned vacation. Students are not granted leave for social events in the family. In case a student absents herself from duty/class for any reasons and the Principal is not satisfied with the explanation regarding her absence, the student will be asked to make up for the number of days she/he was absent, as approved by the Principal, Those not having at least 80% of attendance for any subject will not be permitted to appear for examination.

ACADEMIC PROGRESS AND CLINICAL EVALUATION: All Students are expected to maintain a high academic and clinical standard of performance throughout the program. To this effect regular written and practical sessional examinations will be conducted.

Consistent standards of excellence are expected at all times. Students who do not show any progress or who fail repeatedly will not be allowed to appear for examination / continue the course.

INTERNAL ASSESSMENT: Internal assessment in each subject is carried out at prescribed time and the internal assessment carries allotted weight-age of the total university marks. Passing in the Internal assessment is the pre-requisite to appearing for the University examination.

EXAMINATION: The students will appear for theory and practical examination of the University at the end of every academic year as prescribed. Unit tests and two sessional examinations will be conducted every year by the college. Examination fee, as determined by the University, should be paid by the students.

The examination shall consist of four parts: part I, part II, Part III, Part IV.

All the parts leading to the degree of Bachelor of Science in Nursing will be held once a year followed by a supplementary examination to be held at least 6 weeks after the publication of results will be suggested by the board of studies but determined and notified by the university.

An enrolled candidate of the University from a recognized college, prosecuting the courses of study of the Bachelor of Science in Nursing, shall have to maintain at least 80% attendance in theory and clinical experience separately during that particular year of study to appear in that particular part of the Examination. However, 100% of attendance for practical is mandatory before the award of degree.

  • Non-appearance in any part/subject of the examinations shall be considered as failure and shall be counted as one chance.
  • Candidates who have appeared or who is deemed to appear in all the subjects of Part I, II and III Examination may proceed to take regular course of study in the major and subsidiary subjects of the B.Sc. Nursing course and may be admitted to the subsequent years by giving a declaration to the HOD Nursing.
  • If a candidate fails to clear supplementary exam. for one subject she can sit for next final university examination along with the supplementary subject.
    • A candidate shall have to clear all the previous examinations before appearing for final year examination.
    • Candidates who have failed in any subject of part IV examination may appear in the supplementary / next regular examination being the outsider.
    • If a candidate fails in either theory or practical paper (where applicable) of any subject then she has to reappear for both theory & practical exam. of that particular subject.
    • To complete four years B.Sc. Nursing course a candidate will not exceed a period of maximum eight years

EDUCATIONAL FIELD VISIT : During the course of studies the students will be sent for educational field visit extending over a period of 4-8 days or more.  

GENERAL DISCIPLINE : Nursing Profession, which demands altruistic service from its members, exacts self discipline at a personal level and general discipline in the campus. Therefore:

1. Regular attendance as well as punctuality is expected from the students at lectures, demonstrations, practicals, field work and other such academic exercise as well as experiences. They are required to attend allotted working periods in each of the prescribed subjects.

2. Students should wear the prescribed complete uniform for duty.

3. A sense of decorum and discipline is expected from every student in the college, hospital as well as in the entire campus. Ragging is strictly prohibited. They shall not indulge either individually or collectively, in any form of activity that will bring down the good name of the Institution / Nursing profession. No person who is a student in a educational institution including an institution under the direct management of the University or of the Central Government shall commit ragging. Any person who contravenes subsection shall, on conviction, be punished.

4. Students will strive at all costs to be loyal to the Ethos of the Institution and to promote its image and status by a humane, ethical and professional code of conduct. Failure to follow these and such other regulations will necessitate the management to take disciplinary action as deemed fit.

5. Parent teacher meeting will be held twice a year as well as when required.

FEES : The fees will be charged based on the expenses incurred on education and other facilities offered. Students are expected to meet the expenses. Fees are payable as per the approved rates prescribed from time to time. Fees are liable to be change every year. Revision will be made applicable to all.ION - 9 83

 

 

 

 

 

 

ANNEXURE A

 

AFFIDAVIT BY THE STUDENT

1) I, (full name of student with admission /registration/enrolment number) S/o / D/o Mr. / Mrs. / Ms.

____________________________________________________, having been admitted to (name of the institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institution, 2009, (hereinafter called the “Regulations”) carefully read and fully understood the provisions contained in the said Regulations.

2) I have, in particular, perused clause 7 and clause 9.1 of the Regulations and am aware as to what constitutes ragging.

3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against me in case I am found guilty of or abetting ragging, actively or passively or being part of a conspiracy to promote ragging.

4) I hereby solemnly aver and undertake that a)I will not indulge in any behavior or act that may be constituted as ragging under clause 3 of the Regulations.

b)I will not participate in or abet or propagate through any act of commission or omission that may be

constituted as ragging under clause 3 of the Regulations.

5) I hereby affirm that, if found guilty of ragging, I am liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against me under any penal law or any law for the time being in force.

6) I hereby declare that I have not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging, and further affirm that, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled.

Declared this____________day of______________month of________year.

____________________

Signature of Deponent

Name :

Address:

Telephone / Mobile No.

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (place) on this the (day) _____of (month)___(Year)______________

____________________

Signature of Deponent

Solemnly affirmed and signed in my presence on this the (day) of (month), (year) after reading the contents of this affidavit.

                                                                                                                   

 

 OATH COMMISSIONER

 

STUDENTS ARE REQUESTED TO SUBMIT THE ANTI-RAGGING AFFIDAVIT AS PER THE UGC GUIDELINES. IT IS MANDATORYTOSUBMITTHE ONLINE ANTI-RAGGING AFFIDAVIT ON THE DAY OF REPORTING.

 

 

 

ANNEXURE B

 

AFFIDAVIT BY PARENT/GUARDIAN

1) I, Mr./Mrs./Ms.__________________________________________(full name of parent/guardian)

father/mother/guardian of, (full name of student with admission/registration/enrolment number), having been admitted to (name of the institution), have received a copy of the UGC Regulations on Curbing the Menace of Ragging in Higher Educational Institutions, 2009, (hereinafter called the “Regulations”), carefully read and fully understood the provisions contained in the said Regulations.

2) I have, in particular, perused clause 7 and clause 9.1 of the Regulations and am aware as to what constitutes ragging.

3) I have also, in particular, perused clause 7 and clause 9.1 of the Regulations and am fully aware of the penal and administrative action that is liable to be taken against my ward in case he/she is found guilty of or abetting ragging, actively or passively or being part of a conspiracy to promote ragging.

4) I hereby solemnly aver and undertake that:

a) My ward will not indulge in any behavior or act that may be constituted as ragging under clause 3 of the Regulations.

b) My ward will not participate in or abet or propagate through any act of commission or omission that may be constituted as ragging under clause 3 of the Regulations.

5) I hereby affirm that, if found guilty of ragging, my ward is liable for punishment according to clause 9.1 of the Regulations, without prejudice to any other criminal action that may be taken against my ward under any penal law for the time being in force.

6) I hereby declare that my ward has not been expelled or debarred from admission in any institution in the country on account of being found guilty of, abetting or being part of a conspiracy to promote, ragging, and further affirmthat, in case the declaration is found to be untrue, the admission of my ward is liable to be cancelled.

Declared this____________day of______________month of________year.

____________________

Signature of Deponent

Name :

Address:

Telephone / Mobile No.

VERIFICATION

Verified that the contents of this affidavit are true to the best of my knowledge and no part of the affidavit is false and nothing has been concealed or misstated therein.

Verified at (place) on this the (day) _____of (month)___(Year)_______

__________________

Signature of Deponent

Solemnly affirmed and signed in my presence on this the (day) of (month), (year) after reading the contents of this

affidavit.

                                                                                                             OATH COMMISSIONER

 

 



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