BEFORE THE CONCERNED AUTHORITIES

AFFIDAVIT

I,Aili Pushpa W/o Late Ashok, Age:40 yrs, Occu:Agriculture R/o

Regulagudem villege of Kataram mandal of Jayashankar District do hereby state
on oath as under:-

1. That I am deponent herein,hence I know the facts.

2. That my Husband by name Late Aili Ashok S/o VenkataRajam,Who was died
on:18/12/2020.due to Ill-Health at Govt Hospital Godavarikhani.
3. That in my Husband Death Certificate in calm No.1 My Husband Surname
was Wrongly Entered as Ayili instead of Aili.
4. That I here with filed the Xerox copies of relevant document to support my
contention
5. That I request your authoritoies may be pleased to correction my Husband
Death Certificate and issue to me as early as possible for ends of justice.

That the contents of this affidavit are true and correct best of my
Knowledge, if found to be false I may be punished according to law.Hence
this affidavit

//sworn and Signed before me DEPONENT

On: / /2023 at Mulugu (AILI PUSHPA)