AFFIDAVIT

I, ANDEPAPAIAH GARI SREE LALITHA (Child Mother), W/O BANDI RAMAKRISHNA

(Child Father), aged about 28 years, residing at Door No.26/126, Krishnapuram Village,
Mydukur Mandal, Kadapa District, Andhra Pradesh, India, do hereby solemnly affirm and
state as follows:

That I am the deponent herein and I am fully acquainted with the information given below:

I submit that I applied birth certificate of my Son BANDI THIRUMALA MOKSHITH

(Child Name, correct Name) at Registrar of Birth and Deaths, Mydukur Municipal
Corporation, Mydukur with Registration No.B-2019: 28-15624-000230, dated Issued 06-07-
2019. In the said Birth Certificate of my Son was mentioned incorrectly as follows in the
below table:

S.N RELATION WRONG NAME (mentioned in Birth CORRECT NAME

Certificate)
O
1 CHILD NAME BANDI THIRUMALA MOKSHARTH BANDI THIRUMALA MOKSHITH
Contd…2
 :: 2 ::

I affirm and state that While I was reported to the Mydukur Municipal Corporation
mistakenly my Son name were wrongly mentioned as shown in above table.

I request the Registrar of Birth and Deaths of Mydukur Municipal Corporation

kindly correct my Son names and issue new certificate.

I am herewith enclosing the certificate of birth which was issued by you, for your
kind perusal.

I take oath and solemnly declare/affirm that the particulars furnished by me that the
above are true and correct and that I have not concealed or misrepresented any facts.

The contents of the above affidavit are translated to me.

DEPONENT

Solemnly affirmed and signed before me on this

the 13Th day of June, 2022 at Mydukur.