THE LAKSHADWEEP GAZETTE
1
I N D E X
Part Page
I
........................
Nil
II
........................
Nil
III
........................
Nil
IV
........................
1-4
PRICE : 75 PAISE
VOL. LIX. No. 40 THURSDAY, 1st FEBRUARY, 2024/12th PAUSHA, 1945 (SAKA)
AFFIDAVIT FOR CHANGE IN NAME/DEED POLL/SWORN AFFIDAVIT
By this deed I undersigned THAMEEMA PADIPURA (New Name) previously called as
BEEGAM RAARZIYA & BEEGUM RAZIYA (as mentioned in the passport of my husband)
(Old name) and resident of Padippura, House No.6/174 V(D)P MN. Chemmachery Androth
Island (Address) daughter of Mohammed Basheer Thangal S. do solemnly declare.
1. That for and on behalf of myself my husband, father, mother, children and remitter issue
I wholly renounce/relinquish and abandon the use my former name and surname
BEEGAM RAARZIYA & BEEGUM RAZIYA (as mentioned in the passport of my husband)
and in place thereof I do hereby from this date assume the name/ surname of THAMEEMA
PADIPPURA so that I and my children and remitter issue may hereafter be called,
known and distinguished on former name surname, but assumed the name
surname of THAMEEMA PADIPPURA.
2. That for the purpose of evidencing such my determination declare that I shall at all
hereafter in all records, deeds and in writings and in all proceedings and transactions as
well as in all occasions whatsoever, use and sign the name of THAMEEMA PADIPPURA
as my name surname in place and subtitution of my former name surname.
In the presence of
1. Mohammed Basheer Thangal
Sd/-
Shekkiriyammada House Signed, sealed and delivered by the above name
Androth Island
Thameema Padipura
THE LAKSHADWEEP GAZETTE
2
2. Abdul Raheem NPT Sd/-
Neelathupura Thathada Signed, sealed and delivered by the above name
Androth Island Beegam Raarziya & Beegum Raziya (former Name)
HARSHIT SAINI, DANICS
DEPUTY COLLECTOR
Sd/-
EXECUTIVE MAGISTRATE
ANDROTH
U.T. OF LAKSHADWEEP
PIN-682 551
Solemnly affirmed and signed before me on this 14th day of January 2022.
3. That I expressly request and authorise all people in general and relatives and friends in
particular at all times hereafter to designate and address me my husband and children
and remitter issue by such assumed name surname of THAMEEMA PADIPURA.
4. That in witness hereof I have hereunto my former and adopted name surname of
BEEGAM RAARZIYA & BEEGUM RAZIYA (as mentioned in the passport of my
husband) and THAMEEMA PADIPURA affix my signature and seal if any on this.......
day of January 2022.
In the presence of
1. Mohammed Basheer Thangal
Sd/-
Shekkiriyammada House Signed, sealed and delivered by the above name
Androth Island
Thameema Padipura
2. Abdul Raheem NPT Sd/-
Neelathupura Thathada Signed, sealed and delivered by the above name
Androth Island Beegam Raarziya & Beegum Raziya (former Name)
Solemnly affirmed and signed before me on this 14th day of January 2022.
HARSHIT SAINI, DANICS
DEPUTY COLLECTOR
Sd/-
EXECUTIVE MAGISTRATE
ANDROTH ISLAND
U.T. OF LAKSHADWEEP
PIN-682 551
THE LAKSHADWEEP GAZETTE
3
AFFIDAVIT
I on behalf of my daughter, ISRA ZAYN, POKARAPPADA daughter of Dr. Arif
Mohammed Sagar, Kunnhipuvvakkada of Kalpeni Island residing at Pokarappada
Baniyam, Kalpeni Island, Union Territory of Lakshadweep do here solemnly affirm
and declare that my daughter’s name has been changed and shall be known as ISRA
SAGAR POKARAPPADA.
Sd/-
Dr. ARIF MOHAMMED SAGAR. K. P
KUNNHIPUVVAKKADA
UNION TERRITORY OF LAKSHADWEEP
Solemnly affirmed and signed before me on this 23rd day of November 2023.
Sd/-
EXECUTIVE MAGISTRATE
KALPENI ISLAND
LAKSHADWEEP
BEFORE THE HONORABLE EXECUTIVE MAGISTRATE KALPENI
I have hereunder subscribe my daughter’s name and adopted name of ISRA ZAYN,
POKARAPPADA, Kalpeni Island as ISRA SAGAR POKARAPPADA, Kalpeni Island,
Union Territory of Lakshadweep and signed on this 23rd day of November 2023.
Sd/-
Dr. ARIF MOHAMMED SAGAR. K. P
KUNNHIPUVVAKKADA
UNION TERRITORY OF LAKSHADWEEP
Solemnly affirmed and signed before me on this 23rd day of November 2023.
Sd/-
EXECUTIVE MAGISTRATE
KALPENI ISLAND
LAKSHADWEEP
Affidavit signed before the Honorable Executive Magistrate Kalpeni
My daughter’s name known as ISRA ZAYN, POKARAPPADA (daughter of Dr. Arif
Mohammed Sagar, Kunnhipuvvakkada and Dr. Benhar Mohammed, Pokarappada
Baniyam) aged 4 years residing at Kalpeni Island, Union Territory of Lakshadweep have
changed and shall be known as ISRA SAGAR POKARAPPADA.
I, the undersigned wholly renounce, relinquish and abandon the use of my daughter’s
former name ISRA ZAYN, POKARAPPADA, Kalpeni Island and in place thereof do
assume the name of ISRA SAGAR, POKARAPPADA, Kalpeni Island and so that
there after called, known and distinguished not by her former name, ISRA ZAYN,
POKARAPPADA but by assumed name of ISRA SAGAR, POKARAPPADA, D/O Dr.
ARIF MOHAMMED SAGAR, KUNNHIPUVVAKKADA.
THE LAKSHADWEEP GAZETTE
4
I, declare that I shall at all times in all records, deeds writing, and in all proceedings,
dealings and transactions private as well as public and upon all occasions whatsoever use
and sign the name of ISRA SAGAR POKARAPPADA, as my daughter’s name in place of
and in substitution of her former name ISRA ZAYN, POKARAPPADA.
Sd/-
Dr. ARIF MOHAMMED SAGAR. K. P
KUNNHIPUVVAKKADA
UNION TERRITORY OF LAKSHADWEEP
Solemnly affirmed and signed before me on this 23rd day of November 2023.
Sd/-
EXECUTIVE MAGISTRATE
KALPENI ISLAND
LAKSHADWEEP
AFFIDAVIT
I on behalf of my daughter, ISRA ZAYN, POKARAPPADA, daughter of Dr. Arif
Mohammed Sagar, Kunnhipuvvakada of Kalpeni Island residing at Pokarappada Baniyam,
Kalpeni Island, Union Territory of Lakshadweep do here solemnly affirm and declare that my
daughter’s name has been changed and shall be known as ISRA SAGAR POKARAPPADA,
reason for the aforementioned change being replacement of the surname by father’s
surname as per religious ruling.
Sd/-
Dr. ARIF MOHAMMED SAGAR. K. P
KUNNHIPUVVAKKADA
UNION TERRITORY OF LAKSHADWEEP
Sd/-
KILIYALLOOR MANI
PALAYAM VEDOR
India Institute of Commerce Bldg.
University P. O. Thiruvananthapuram.
Round Seal
LGP.Kvt.K-2518/02-2024/15
No legal Responsibility is accepted for the publication of advertisement regarding
change of names and other private notifications in the Gazette. Person notifying the
same will remain solemnly responsible for the legal consequence and also for any other
representations etc.
/ Approved /
Sd/-
DIRECTOR
Printing & Stationery.