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One and Same Person Affidavit

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Title

Applicant Name

Relation *

Guardian's Name *

Age *

Address *

Name as in First Record *

First Document / Record *

Name as in Second Record *

Second Document / Record *

Reason for Difference

Submission Authority

Verification Date

EDrafted

ONE AND SAME PERSON AFFIDAVIT

I, Miss., S/o ____________, aged about ____________ years, R/o ____________, do hereby solemnly affirm and declare as under:

That my name is recorded as ____________ in ____________.
That my name is recorded as ____________ in ____________.
That the names “____________” and “____________” refer to one and the same person, i.e., myself.
That the difference in my name is due to ____________.
That I have not misused or fraudulently used either of the above-mentioned names.
That I request the concerned authority/department/institution to treat both the above-mentioned names as belonging to one and the same person, i.e., myself.
That this affidavit is being executed for submission before ____________ for the purpose of establishing my identity and confirming that both names belong to me.
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 my knowledge and belief and nothing material has been concealed therefrom.

Verified at ____________ on ____________.

DEPONENT

Signature:

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One and Same Person Affidavit