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Format of affidavit for Renewal of Registration (As per Sec.23 of
MMC Act,1965)
The Notaries Affidavit on Non judicial Stamp Paper (Rs. 100/-) with
photo identity declaring reason for delay in Renewal of Registration,
as follows.
I Dr........................................................... Reg. No...... age ....., occupation
.......................... Residing at .......................................................................
do solemnly affirm and state that :
A. I say that I am duly registered with MMC vide Reg. No. .......... Reg.
dt............ & ought to have renewed on .............. . I say that, I have
not renewed my registration on previous renewal programme due
to (State Reason)...............................................................................
...........................................................................................................
B. I say that, I have not been found guilty in any court of law or by
MMC till date.
C. I say that, there is no civil /criminal case/writ petition against me in
any court till date.
D. I say that, I have not done any unethical / professional mis-conduct
in past i.e. during register period as well as during non renewal
period.
E. I say that, I shall be held responsible, if it is proved or found later on
that I have done any unethical/ unlawful deed in past during non-
renewal period, the Maharashtra Medical Council shall have liberty
to pass such appropriate order as to registration /renewal or even
removal.
F. There is no complaint filed or pending against me in the MMC/ any
other state medical Council or Medical Council of India, New Delhi
till date.
G. I say that, I undertake to pay the requisite fees for renewal & late
fees as per Sec.23 of MMC Act and directions of the Council for
considering my application for renewal.
I am swearing this affidavit to produce before the Registrar of MMC,
Mumbai and/or any other concerned authorities, to take the above facts on
record. I further say that, I undertake to furnish all requisite original
documents and requisite fees as per Rules.