resident of ‘A’ Wing, S-2, Devkripa Building, Plot No. 16/17, Nathpai Nagar, Viraj Barvali Galli, Ghatkopar (East) Mumbai – 400077., hereby state the following::- 1) I was born on 10.6.1940 at Mahanwad, situated in the district Valsad in the State of Gujrat I have no documentary proof in support of my place and date of birth.
2) I do not possess any educational qualification and I am an
illiterate person.
3) I take oath and solemnly declare/affirm that the particulars
furnished by me above are correct and that I have not concealed or misrepresented any facts.