FORM-101F (APPENDED TO FORM 101)

(See rule 5)

Declaration

(1) I_______________.______. of

the above enterprise declare that information of all the,-

(i) properties,

(ii) bank accounts and

(iii) places of business

held severally and jointly in the name of proprietor/each partners/each members of HUF/each directors of company/each members of the managing committee of the association/persons having any interest in the business in Gujarat State or outside Gujarat State have been mentioned in Form 101.

(2) I further declare that no information as referred above has been hidden and any change occurs in future shall be informed to the registering authority in prescribed time.

(3) I am well aware about the action of prosecution by the registering authority and the penalty and punishment for the offence of hiding any such information which is found in future.