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I PRIYANKA PANDEY D/O OF PYARE LAL MISHRA R/o H.NO.

S-2/350-C-1
SIKRAUL VARANASI do hereby declare as under:.

That my Date of Birth is 10/12/1984 as mentioned in my Pan Card but in my address

proof it is mentioned as 09/12/1984


That I am giving the declaration that 10/12/1984 is the correct Date of Birth.

That I state and hereby approve that the statement made above in the clauses are true to
the best of my knowledge and belief.

That the above declaration is being made in full conscious state by me.

Date 05/08/2016

PRIYANKA PANDEY

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