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Draft An Affidavit As A Proof of Age Showing The Date of Birth of 'A
Draft An Affidavit As A Proof of Age Showing The Date of Birth of 'A
ITANAGAR/NAHARLAGUN/BANDERDEWA
AFFIDAVIT
I Shri/Smt. Suman Kumar, daughter of Shri Tarak Gupta, Permanent resident of village
Naharlagun, Distt.- Papum Pare, State of Arunachal Pradesh and presently residing at ward No-
24 Of D-Sector, Sector of Itanagar/Naharlagun/Banderdewa, District Papum Pare.
DECLARATION
I Shri /Smti. Suman Kumar do hereby declare that the above statements from Para 1 to 4 are true
to the best of my knowledge and belief, if I am furnished wrong information, I shall be liable to
punishment under the registration of Birth and Death Act,1969.
DEPONENT
Executed and signed before me by Shri/Smti. Suman Kumar in my court on this 13 day of
October,2022. (ALL BLANKS IN THIS SECTION TO BE FILLED BY THE
MAGISTRATE).
EXECUTIVE MAGISTRATE