TEN

andra, Com
RUPEES
KADH5f6591
SfsathyaSaioist.
GOMSNOTAD
Rs.10
INDIA

INDIANON JUDICIAL
so0 AT YENT ANDHRA PRADESH
S.a2A78. Stanp Vendor
Licence No. 12-08-04/2023
Obuladevara Cheruvu
Ceil: 9505318535
AFFIDAVIT FOR CHILDNAME INCLUSION IN BIRTH
I, ERAMAPPA, S/o E CERTIFICATE
A
Kothapalli , GANGULAPPA aged about 47 years, Hindu, resident of
solemnly affirmAmadagur, Amadagur
and state as follows: Mandalam, Sri Satya Sai District, D.No.6/127,
Andhra Pradesh, do hereby
1) That I anm the deponent herein. My
Daughter namely EDAGOTTUPALLAVI, was born on
06/11/2008,Srithrough my Wife, EALIVELAMMA
Mandalam, Satya Sai District, Andhra Pradesh at.TheGovt Hospital , Amadagur, Amadagur
also registered the birth bearing No. Amadagur Mandal
name inclusion of my Daughter and for Grant of Hence Iam making this Authorities
declaration
has
for
Date of Birth Certificate.
2) Hence I am making this declaration for
my Daughter name. Grant of Date of birth Certificate by
inclusion of
3) By affirmation IIam declaring that the above facts are
and belief. correct to the best of my
knowledge

Solemnly affirmed and signed before me on this the

21/11/2023, at Kadiri, Sri Satya Sai District.

IATTESTETI K. Ravindra, B.Com., B.L.,

NOTARY
KADIRI, Sri Sathva Dist. A. P.