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Dual Name Affidavit

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Title *

Applicant Name

Relation *

Guardian's Name *

Address *

Name as in First Records *

Name as in Second Records *

Verification Date

EDrafted

AFFIDAVIT

I, Miss., S/o ____________, resident of ____________, do hereby solemnly affirm and declare as under:

That my correct name is Miss..
That in certain records/documents, my name has been mentioned as ____________, whereas in other records/documents, my name has been mentioned as ____________
That both the names, ____________ and ____________refer to one and the same person, i.e., myself.
That the difference in the names has occurred due to clerical error, spelling variation, abbreviation, omission/addition of surname, or usage in different documents, and there is no intention to misrepresent my identity.
That I declare that I shall be known and identified by the name Miss. for all present and future purposes.
That this affidavit is executed to certify that both the above-mentioned names belong to one and the same person and to produce the same before the concerned authority wherever required.
That the contents of this affidavit are true and correct to the best of my knowledge and belief, and nothing material has been concealed therefrom.

DEPONENT

VERIFICATION

I, Miss., the above-named deponent, do hereby verify that the contents of this affidavit are true and correct to the best of my knowledge and belief, and that nothing material has been concealed therefrom.

Verified at ____________ on this ____________.

DEPONENT

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