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Before Executive Magistrate, Bokaro Declaration

BY THIS DEED I, named Kumar Rajnish S/O- Ram Suresh


singh R/o Phase-1, Plot No.- 503a-061, K.K.Singh Housing Colony , Rajendra Nagar Chas, Bokaro Steel City, Distt.- Bokaro, Jharkhand aaged about 44 years by faith Hindu by Profession Serviceman do solemnly declare:1. That my daughter who is the student of Guru Govind Singh Public School, Sec-V, B.S.City having registration No-04/P/10 wholly renounce/relinquish and abandon the use of her former name Shefali and in place of thereof she hereby assume from this date hereof the name Shefali Singh And so that my daughter may hereinafter be called known and distinguished not by her former name but assumed name of Shefali Singh. 2. That for purpose of evidencing I declared that my daughter shall all times hereafter in all records, deeds and writings and in all proceedings and transactions private as well as public use sign the name of Shefali Singh in substitution for her former name of Shefali.

3. That I expressly authorize and request all persons at all times hereafter to designate and address my daughter by such assumed name of Shefali Singh accordingly. 4. IN witness where of I have here into subscribed the former name and assumed name of my daughter accordingly.

Shefali Former Name of my Daughter

Shefali Singh Assumed Name of my Daughter

Verification Statements made above are true and corret and I sign Deponent Identified by me

Advocate

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