AFFIDAVIT

I________________________, do hereby solemnly affirm and declare as under:-

1. That I have changed my name from _______________to _______________.
2. That henceforth I would e known as ____________________for all intents
and purposes in future.
3. That in future my name will be inserted as ___________________ in my
service record and all my documents.
4. That no case is pending against me in any court of law or police department
anywhere in India or anywhere else.
5. That I am furnishing this affidavit to for the publication in the News paper.

Place:
Dated:
DEPONENT

VERIFICATION

Verified that the contents of the above affidavit are true and correct to
the best of my knowledge and belief and nothing has been concealed therein.
DEPONENT
Place:
Dated: