Before the Registrar ………………..University . ………………..

Affidavit of Km . …………………………………..
now Smt ………………………………..…………..
aged about ………………..years,
wife of Shri………………………………… ……..
resident of……………………………………………………………………………………………

I, the above named deponent, solemnly affirm and state as under:

1. 1.       That I am the applicant in the application submitted for the change of name and as such I am fully conversant with the facts deposed to below.
2. 2.       That I passed my ………………..Examination with Roll No ………………..from ………………..University in the year 1986 with my name Km . ………………..
3. That I am the daughter of Shri ………………..At the time of my admission to the school, my name was Km . ……………….. which continued till my marriage with Shri ………….in ………………..
4. That after my marriage with Shri ………………..due to change in surname of my husband, my name has changed from Km …………………………………. to Smt .

5. That I have been appointed as ………………..in …………and the appointing authority has asked me to submit the certificate issued by the University with the changed name.

6. That I who is now called as Smt ………………..is the same person as Km . ………………..before my marriage with Shri

7. That as required by the I it is necessary to issue certificate in the changed name.

I the above named deponent, do hereby declare and verify that the contents of paragraphs 1 to 7 of this Affidavit are true to my knowledge, nothing material has been concealed and no part of it is false. So help me God.

Verified at…………………….this…………………….day of…………………….20…………………….
Date……………………. Deponent