: DEED POLL AFFIDAVIT :

By this deed I, SAYYED NAJMA FATIMA (NEW NAME), the

undersigned previously called NAZMA KALBE HUSSAIN SAYYED
(OLD NAME), A Student, and resident of 3 Azrura Chawl, Wahid
Society , J.P. Road, Near Rizam Society, Gate No.7, Malad West,
Mumbai 400095, solemnly declare:-
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1. That for and on behalf of Myself remitter issue wholly

renounce/relinquish and abandon the use of my former
name NAZMA KALBE HUSSAIN SAYYED and in place
thereof I do hereby assume from this date the name
SAYYED NAJMA FATIMA and so that I remitter issue may
hereafter be called, known and distinguished not by my
former name but by assumed name of SAYYED NAJMA
FATIMA.

2. That for the purpose of evidencing such my determination

declare that I shall at all times hereafter in all records, deeds
and writings and in all proceedings, dealings and
transactions, private as well as upon all occasions what-so-
ever use and sign the name of SAYYED NAJMA FATIMA as
my name in place and in substitution of my former name.

3. That I expressly authorize and request all persons in general

relatives and friends in particular at all times hereafter to
designate and address me remitter issue by such assumed
name of SAYYED NAJMA FATIMA accordingly.
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4. In witness whereof I have here unto subscribed my former

and adopted name of SAYYED NAJMA FATIMA.

SIGNED, SEALED AND DELIVERED )(

by withinnamed )(
SAYYED NAJMA FATIMA )(
in the presence of ……………………. )(
on 24th day of May 2017 )(

former name NAZMA KALBE HUSSAIN SAYYED

In the presence of .................................

1) Witness Name and Address :

ZAID ABBAS SHAIKH, Room No.1510, Chawl No.154, M.H.B.
Colony, Abdul Hamid Road, Gate No.8, Malad West, Mumbai
400095

Signature :

2) Witness Name and Address :

IMTIYAZ ZAIDI SAYYED, Room No.122, Chawl No.16, Gate No.7,
M.H.B. Colony, Near Shankar Mandir, Marve Road, Malwani, Malad
West, Mumbai 400095

Signature :

Identified & Explained by me,

Advocate, High Court.