| राजस्थान राज-पत्र साधारण | RAJASTHAN GAZETTE Ordinary | |
| साधिकार प्रकाषित | Published by Authority | |
| जिल्द 77 आषाढ़ 5, गुरुवार, शाके 1947-जून 26, 2025 अंक 13 Vol. 77 Asadha 5, Thursday, Saka 1947-June 26, 2025 No. 13 |
भाग 7 विभिन्न विभागों में प्रदायों के लिए टेण्डर मांगने की सूचनाओं को सम्मिलित करते हुए सार्वजनिक और निजी विज्ञापन आदि।
SPECEIMEN AFFIDAVIT FOR CHANGE IN NAME/DEED POLL/SWORN AFFIDAVIT (On non-judicial stamp paper)
By this deed I, the undersigned SAMPATI DEVI (New Name) previously called SANPATI DEVI (Old name), doing Homemaker (give profession or vocation) and R/o, Wife of Hukam Chand] Ward No. 13, Station Road, Ranoli Tehsil Dantaramgarh District Sikar (RAJ.) solemnly declare :-
1. That for and on behalf of myself and my parent and children and remitter issue wholly renounce/relinquish and abandon the use of my former name of SANPATI DEVI and in place thereof I do hereby assume from marriage date the name SAMPATI DEVI and so that I and my parent, children and remitter issue may hereafter be called, known and distinguished not by my former name, but assumed name of SAMPATI DEVI.
2. That for the purpose of evidencing such my determination declare that I shall at all times hereafter in all records, deeds and writings and in all proceedings, dealings and transactions, private as well as upon all occasions whatsoever use and sign the name of SAMPATI DEVI as my name in place and in substitution of my former name.
3. That I expressly authorize and request all persons in general and relatives and friends in particular, at all times hereafter to designate and, address me, my parent, my children, remitter issue by such assumed name of SAMPATI DEVI accordingly.
4. In witness whereof I have hereunto subscribed my former and adopted name of SAMPATI DEVI and affix my signature.
Place : Sikar Date : 26-05-2025 सम्पति
Signed and delivered by the above name Former name" SANPATI DEVI " New Name" SAMPATI DEVI "
ATTESTED
CHAIN SINGH KHEDAR
26-05-2025
NOTARY PUBLIC
SIKAR-RAJASTHAN.
6376