To, Date: ACY O4 OM 2015 Flipkart Internet Private Limited Place: Ozone Manay Tech Park, 'B' Block, 7th Floor, Survey No. 56/18 & 55/9, Hosur Road, Garvebhavipalya Bangalore-560068 Banga)ore ~N DECLARATION CUM UNDERTAKING Tree hundred and Ref: Refund of Rs._24 9 _/ (Rupees inst ine Only) in lieu of return/reject of (referrel to (mention product description) (1 as ‘Product’. Dear Sir/Madam, 1 S(DWIo. Beteioa Baths an Indian inhabitant residing wet ft eobess. Mare Oro Eongatere o O) hereby, declare that | have placed order for the Product vide order No Qbi922588, said Product is returned for the reason (A eee ae (mention reason). Further I, state that the payment made with respect to the Product ié paid through bank account held by third Party i.e..Mr/Ms./Mrs§ We i t Shara. with Account No. ANAS BS AAS ., Sire Boas Od. noLia_ Bank Aernaghad\Branch, IFSC Code: PIN OOS +4 “nree, hucdread. & Hiway Irequest you to refund Rs.__ cy J (Rupees Po Only)tothe aforesaid account by way of electronic fund transfer and | hereby agree and undertake that the. refund made in the aforesaid manner shall give Flipkart.com valid and complete discharge in respect of the Flipkart’s obligations to.refund the aforesaid amount to me. Thereby agree to indemnify and keep you fully and effectively indemnified of, from and against all costs charges and/or expenses that may be-caused to or suffered by you, as a result of any future claims on the refund/Product by me and/or from any one claiming under. me. | shall not dispute or contest the existence, execution, veracity or validity this Document. Your's faithfully (Neme:_Crais ro Contact Number VAR INE Va La / —