AFFIDAVIT

I -------------------- (OLD NAME) daughter/Son of.................. (Father Name)

aged....... (Age) residing
at..................................................................................................................
................................ (Please mention full present address) do hereby
solemnly affirm and declare as under:

1) That my name is ...................(old name)

2) That i want to change the name as ............................(new name) as
there is.............................................(reason for name change)
3) I state that.................... (Old name) and the................. (New name)
the name of one and the same person and that is myself.

I am executing this declaration to be submitted to the concerned authorities

for the change of name

Old Name: ................................................

New Name: ..............................................

I hereby state that whatever is stated herein above are true to the best of my
knowledge.

Date: ...........................

Signature ..................................