From: Head Master

Sir Syed Higher Secondary School

Taliparamba.P.O - 670141
To : The Joint Commissioner for Govt. Examination
Pareeksha Bhavan
Thiruvanathapuram
Sir,
Sub:

Request for Correction of date of birth in the school record application

received from SHABEEL.E.K, a student of this school appeared SSLC
Examination March 2010- reg.
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I am submitting herewith an application received from SHABEEL.E.K, a student,

appeared S.S.L.C Examination March 2010, from this school, residing at Faseeha Manzil,
Natuvayal, P.O.Taliparamba, Kannur District 670141, for making correction of date of birth in the
school record and SSLC card of the pupil. Application in the prescribed form along with the
following documents is submitting herein for your verification.
1. Application form duly signed by the applicant SHABEEL.E.K
2. Statement showing the particulars of Educational Institutions Attended from std I to X.
3. Certificate of the Head of School to which the applicant last attended
4. Original Birth certificate of applicant SHABEEL.E.K, Reg.No. 2469/1994 dated 9.7.1994
and its 3 attested copies.
5. Chalan receipt No.115 dated 10.02.2012 for Rs.500/- of SBI, Taliparamaba.
6. Original SSLC card No.096322 of applicant SHABEEL.E.K Reg.No.123133/March 2010
Yours faithfully

Place: Taliparamba
Date: 27.2.2012