AFFIDAVIT

I, KANCHAN KUMAR SINGH, 48-Years Old, Father of KANYA

SINGH, 14-Years Old, residing
at____________________________________________
________________________________________________, do hereby on
solemn affirmation state and declare as under: -

1. That my daughter namely_______________________ is studying in

Class___ in (name of the school and Address).
That Municipal Corporation of (Greater Mumbai – any other
place) had issued my son’s / daughter’s birth Certificate Reg.
bearing No. _____ dated -___/___/___. I further state that in the
said Birth Certificate there are some mistakes and omissions
which I want to rectify as under:

2. In the said Birth certificate, my daughter’s full name is not

mentioned. I state that my son’s/ daughter’s full name is
(Student’s full Name).

3. In the said Birth certificate, my name has been wrongly

mentioned as (name of the parent ‘ABC’) instead of the correct
name i.e. (name of the parent ‘XYZ’) (I have annexed the Xerox
copy of the PAN Card, Voter ID, Aadhar Card (any Photo
Identity) for my name proof). I say that all names (name of the
parent ‘ABC’) and (name of the parent ‘XYZ’) relate to the same
person.

4. In the said Birth certificate, my wife’s name is not mentioned. I

state that my wife’s full name is (name of the wife) and her
surname is (surname). (I have annexed the Xerox copy of the
PAN Card, Voter ID, Aadhar Card (any Photo Identity) for my
wife’s name proof). (Signature of the parent)
5. I state that my son’s/ daughter’s full name is (Full name of the
student), my name is (Full name of the parent) and my wife’s
full name is (full name of wife). 4. That I further state that I
have made this affidavit for recording the below mentioned
correct details in the school’s record. Name of the Pupil:- Name
of the Father:- Name of the Mother:- Date of Birth (in words
and figures):- Religion:- 5. That whatever stated hereinabove is
true and correct to the best of my own knowledge and nothing
has been suppressed and if any thing goes wrong then I will be
held responsible. Solemnly affirmed at (name of the place) On
this ___day of August, 2013 (Signature of the parent)
(Signature and Stamp of name, qualification and registration
number of the notary lawyer) (Signature and Stamp of name,
qualification and designation and office address of the lawyer/
advocate) Identified

BY ME

BEFORE ME