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cu agpoor$/ SeIf Declaration

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cD0o6r.tdruu@6 5rd'u6E sdlco,.ir 6r.i's ruB.oalcollro !-o$ur.f,.rlh@6h.

I am Shrl v Monish Pra.anth ton ofThiru Venkatesh E reriding at Ooor No, 8, street of N.V.
N Street (odungaiyu. vlllaqe / town of Kondunqaiyur, Taluk of Perambur, Chennai Dlstrlct, Tamil
Nadu Stat€- The detailt fur.ished by me are rue ro rhe besr of my knowledge add believe and
nothing has bee. concealed hereln. I declare that lah well aware ofthe fact thar ifthe info.Farlon
and docunerts sjven by me are proved to be ihcorect / nor true in future, I shall be liable for
prosecution und€rse.tio. 177 & 199 ofthe tndian PenalCode.

<-)
st8n.t(. ol tLe applt€n! / osdrnrddr &.6urnu'n

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