Panaji, 28th May, 2020 (Jyaistha 7, 1942)

SERIES III No. 9

RNI No. GOAENG/2002/6410

PUBLISHED BY AUTHORITY

Reg. No. G-2/RNP/GOA/32/2018-20

199

Suggestions are welcomed on e-mail: [email protected]

GOVERNMENT OF GOA

Department of Tourism

___

Order

No. 5/N/TTR(1901)/20-DT/31

The registration of Vehicle No. GA-01/Z-5213

belonging to Shri Ravindra D. Salgaonkar, resident

of H. No. 1146/B, Bammon-Vaddo, Siolim, Bardez,

North Goa, under the Goa Registration of Tourist

Trade Act, 1982 and Certificate issued through

GEL is hereby cancelled as the said Tourist

Taxi has been privatized, with new Registration

No. GA-03-Z-1781.

Panaji, 20th May, 2020.— The Dy. Director of

Tourism & Prescribed Authority (North Zone),

Rajesh Kale.

———¿¿¿———

Advertisements

In the Court of the Civil Judge,

Senior Division at Mapusa

Matrimonial Petition No. 158/2018/C

Crystal Scarlet Maccann,

w/o Mr. Vignesh Mahadev Shivji,

age 35 years, self-employed,

Indian National,

r/o H. No. 1609, Baman Waddo,

near Anjuna Petrol Station,

Grand Chivar, Anjuna,

Bardez-Goa

.... Petitioner.

Versus

Mr. Vignesh Mahadev Shivji,

s/o Mahadev Dattaram Shivji,

major of age 36, service,

r/o 167/2/8, Bella Vista Vaddo,

Sircaim, Tivim, Bardez-Goa

.... Respondent.

(above are registered addresses)

Notice

It is hereby known to the public that by

Judgement and Decree dated 29-11-2019, passed

by this Court the marriage between the Petitioner

Crystal Scarlet Maccann, w/o Mr. Vignesh Mahadev

Shivji, age 35 years, self-employed, Indian National,

r/o H. No. 1609, Baman Waddo, near Anjuna Petrol

Station, Grand Chivar, Anjuna, Bardez-Goa, and the

Respondent Mr. Vignesh Mahadev Shivji, s/o

Mahadev Dattaram Shivji, major of age 36, service,

r/o 167/2/8, Bella Vista Vaddo, Sircaim, Tivim,

Bardez-Goa, registered before the Civil Registrar of

Bardez at Mapusa against entry No. 1012/2011 of

the Marriage Registration Book for the year 2011 is

ordered to be cancelled.

Given under my hand and the seal of the Court,

this 13th day of March, 2020.

Carlos Santana da Silva,

Ad hoc Senior Civil Judge,

‘C’ Court, Mapusa.

V. No. AP-56/2020.

———¿———

In the Court of the Civil Judge,

Senior Division ‘A’ Court at Panaji

Matrimonial Petition No. 08/2008/A

Shri Prakassa Nuno Azavedo,

aged 47 years,

SR II Bldg., Flat No. G-8,

Navelkar Hill City, Sao Pedro,

Panvalim, Tiswadi-Goa

.... Petitioner.

Note:- There is one Supplement to the Official Gazette,

Series III No. 8 dated 21-05-2020 namely,

Supplement dated 26-05-2020 from pages 133 to

198 regarding Form No. V from Department of

Revenue (Office of the Collector, North Goa

District, Panaji-Goa).

200

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES III No. 9

28TH MAY, 2020

V/s

Cynthia Maria Fernandes,

aged 43,

c/o Mrs. Anita Fernandes,

“Madonna”, 1022/1,

Geetanjali Layout, New Tippasandra,

Bangalore - 560 075

.... Respondent.

Notice

2. It is hereby made known to the public that by

Judgement and Decree dated 01-08-2018 the

marriage between the Petitioner and the

Respondent stands dissolved. The Civil Registrar-

-cum-Sub-Registrar Ilhas is directed to cancel the

said marriage registration against entry

No. 194/1995 from the Marriage Registration Book

for the year 1995.

Given under my hand and the seal of the Court

of 22nd day of May, 2020.

Artikumari N. Naik,

Ad hoc Senior Civil Judge,

‘A’ Court, Panaji.

V. No. AP-55/2020.

———¿———

Office of the Civil Registrar-cum-Sub-Registrar and

Notary Ex Officio (Special Notary) in this Judicial

Division of Bardez, Mapusa

___

Smt. Sunanda Gauns, Joint Civil Registrar-cum-Sub-

-Registrar and Notary Ex Officio (Special Notary)

in the said Judicial Division.

3. In accordance with Section 346(11) of the Goa

Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public

that by a Notarial Deed of Inheritance dated

12-03-2020, drawn by and before me Smt. Sunanda

Gauns, Joint Civil Registrar-cum-Sub-Registrar

Notary Ex Officio (Special Notary), Bardez at Mapusa

at page 55 to 56v of Notarial Book No. 868 of this

office the following is recorded:-

That late Shri Ricardo Caetano Coelho who

expired on 9-12-2015 and his wife late Smt. Maria

Clarissa Coelho 02-11-2013, both resident of H. No.

407, Podval Vaddo, Aldona, Corjuem, Bardez-Goa,

both died leaving behind their one son namely Shri

Joel Agnelo Coelho, s/o late Shri Ricardo Caetano

Coelho, aged 19 years, bachelor, student, Indian

National, Aadhar card No. 3569 9041 6027,

r/o H. No. 407, Podwal, Aldona, Mapusa-Goa and

the sole and universal heirs and succession of the

above deceased persons who according to law may

have preference over them or who may conquer

with them to the estate left behind by the said

deceased person.

Mapusa, 12th March, 2020.— The Special Notary

Ex Officio, Smt. Sunanda Gauns.

V. No. AP-47/2020.

_________

Smt. Sunanda Gauns, Joint Civil Registrar-cum-Sub-

-Registrar and Notary Ex Officio (Special Notary)

in the said Judicial Division.

4. In accordance with Section 346(11) of the Goa

Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public

that by a Notarial Deed of Inheritance dated

13-05-2020, drawn by and before me Smt. Sunanda

Gauns, Joint Civil Registrar-cum-Sub-Registrar

Notary Ex Officio (Special Notary), Bardez at Mapusa

at page 78 to 80 Notarial Book No. 868 of this office

the following is recorded:-

That Mr. Saluzinho Natividade Fernandes alias

Saluzuilo Natividade Fernandes, expired on

9-11-2014 (nine eleven two thousand fourteen) at

Holy Cross Hospital Remanso, Mapusa-Goa and his

wife Mrs. Graciana Fernandes @ Sebastiana

Graciana Fernandes expired on 10-05-2013 (ten five

two thousand and thirteen) at Galaxy Hospital

Salpem, Duler, Mapusa without any Will or

testamentary of their last disposition but leaving

behind their children as their sole and universal

heirs i.e. one son and one daughter namely a) Mr.

Pedro Filipe Fernandes, s/o of late Saluzinho

Natividade Fernandes alias Saluzuilo Natividade

Fernandes, 60 years of age, married, Indian National

and his wife Mrs. Tecla Fernandes, w/o Pedro Filipe

Fernandes, 60 years of age, both residents H. No.

1026/1, Tarachi Bhat, Siolim, Bardez, Oxel, North

Goa 403 517 and b) Mrs. Natalina Joaquina

Fernandes, d/o Saluzinho Natividade Fernandes alias

Saluzuilo Natividade Fernandes, 57 years of age

and her husband d) Mr. Agnelo Fernandes, s/o late

Mariano Xavier Fernandes, 66 years of age, both

r/o H. No. 445/A, Danda Vaddo, Siolim, Bardez, North

Goa. There are no other person who as per prevailing

law in force who may be preferred to the aforesaid

heirs and who may have better claim or title to the

estate and assets left by the said deceased Mr.

Saluzinho Natividade Fernandes Saluzuili

Natividade Fernandes and his wife Mrs. Graciana

Fernandes alias Sebastiana Graciana Fernandes.

That the estate left behind by the decased does not

exceed the notional value and therefore the

publication may be done in the Official Gazette

and in the local newspaper that the decalarants

are neither successors of the deceased nor do they

have any impediment for this act and that have no

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES III No. 9

28TH MAY, 2020

201

interest in making the present declaration which

they make under oath and at the request of the

party of the other part.

Mapusa, 20th May, 2020.— The Special Notary

Ex Officio, Smt. Sunanda Gauns.

V. No. AP-57/2020.

———¿———

Office of the Civil Registrar-cum-Sub-Registrar and

Special Notary (Ex Officio) of Tiswadi Judicial

Division at Panaji

___

Smt. Aarti A. Parvatkar, Joint Civil Registrar-cum-

-Sub-Registrar and Special Notary (Ex Officio) of

Tiswadi Judicial Division at Panaji-Goa.

5. In accordance with the Section 346 (11) of

“The Goa Succession, Special Notaries and Inventory

Proceeding Act, 2012”, it is hereby made public

that by a Notarial Deed of Legal Succession and

Qualification of Heirs dated 20th May, 2020

recorded before me in Book No. 744 of Notarial Deeds

at page 42v onwards the following is noted:-

That Mrs. Maria Lactancia Torrado Miranda e

Rego, expired on 13-04-2018 in G.M.C., Bambolim-

-Goa. Subsequent to which a Deed of Legal

Succession and Qualification of Heirs dated

19-06-2018 was drawn up in this office,

subsequently on 29-11-2019 expired her husband

Shri Joseph Joaquim Santana Rego at G.M.C.,

Bambolim-Goa, leaving behind their two children,

daughter Miss Keziah Maria Aurora Rego, unmarried

and a son Mr. Kish Anthony Francisco Cosme Da

Santana Rego, unmarried, both as their universal

heirs and besides the above two heirs, there are no

person or persons competent in law to succeed,

concur or compete to the inheritance of the

aforesaid deceased.

Any person having objection to this deed may

file in this office within one month from the date of

its publication.

Panaji, 26th May, 2020.— The Special Notary (Ex

Officio), Aarti A. Parvatkar.

V. No. AP-58/2020.

———¿———

Office of the Civil Registrar-cum-Sub-Registrar and

Special Notary, Ponda

___

Shri Hanumant G. Dessai, Civil Registrar-cum-Sub-

-Registrar and Special Notary Ex Officio of this

Judicial Division of Ponda-Goa.

6. In accordance with Section 346(11) of “The

Goa Succession, Special Notaries and Inventory

Proceeding Act, 2012”, it is hereby made public

that by Notarial “Deed of Succession” dated 13th

day of February, 2020, drawn by and before me Shri

Hanumant G. Dessai, Special Notary Ex Officio,

Ponda recorded at pages 33v to 35v of the Book No.

426 it has been declared as follows:-

That Mrs. Sharada Shripad Patil alias Sharada

Patil expired on 20-07-2019 at Thal Shiroda,

Ponda-Goa in the status of married without

executing any Will or any other disposition in

respect of her estate leaving behind her husband

Mr. Shripad G. Patil alias Shripad Patil alias Shripad

Govind Patil as moiety holder/half sharer and her

only son Shri Govind Shripad Patil, unmarried,

residents of House No. 1196, Thal Shiroda,

Ponda-Goa as legal heir.

That besides the said heirs prevailing in Goa

may concur with them to the estate left by the

deceased person.

Any person having objection to this deed may

file in this office within one month from the date of

its publication.

Ponda, 18th March, 2020.— The Special Notary,

Hanumant G. Dessai.

V. No. AP-51/2020.

———¿———

Office of the Civil Registrar-cum-Sub-Registrar and

Special Notary Ex Officio in this Judicial Division of

Mormugao, Vasco-da-Gama

____

Shri Kiran H. Mesta, Civil Registrar-cum-Sub-

-Registrar and Notary Ex Officio (Special Notary)

Mormugao, Judicial Division at Vasco, Goa.

7. In accordance with Section 346(11) of “The

Goa Succession, Special Notaries and Inventory

Proceeding Act, 2012”, it is hereby made public

that by a Notarial Deed of Succession and

Qualification of Heirs, dated 19-05-2020, drawn by

and before me Shri Kiran H. Mesta, Civil Registrar-

-cum-Sub-Registrar and Notary Ex Officio (Special

Notary), Mormugao at Vasco-da-Gama at pages 63v

to 65v of Notarial Book No. 192 of this office, the

following is recorded:-

That Shri Jose Fernandes expired on 24-04-1981

at Quelossim and that his wife Smt. Graciana

Fernandes expired on 21-10-2000 without executing

any Will or Gift or any other testamentary

disposition of their last wish leaving behind them

their sole and universal legal heirs their children

namely (one) Mr. Agostinho Fernandes, major in

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OFFICIAL GAZETTE — GOVT. OF GOA

SERIES III No. 9

28TH MAY, 2020

age, married to Mrs. Rosada Benvinda Temudo, major

in age. The said Mr. Agostinho Fernandes expired

on 17-07-1997 at Goa Medical College, Bambolim,

Goa and his wife Smt. Rosada Benvinda Temudo

expired on 11-11-2015 at Goa Medical College,

Bambolim, Goa without executing any Will or

Gift leaving behind their children namely

(a) Mrs. Graciana Fernandes, major in age, married

to Mr. Peter Joseph Constantino Fernandes, major

in age (b) Mrs. Fatima Fernandes, major in age,

married to Mr. Maxy Cyril Rodrigues, major in age

(c) Mrs. Milagrina Fernandes, major in age,

married to Mr. Francisco Gama, major in age

(d) Mrs. Lourenca Piedade Fernandes, major in age,

married to Mr. Francisco Xavier Souza, major in age

(e) Mrs. Esmeralda Sonifa Fernandes, major in age,

married to Mr. Nelson Damaciano Manuel D’Cruz

(f) Mr. Jerold Aloyis Fernandes, major in age, married

to Mrs. Flora Gomes, major in age (two) Mr. Piedade

Fernandes, major in age, married to Mrs. Luisa Maria

Fernandes. The said Mr. Piedade Fernandes expired

on 14-12-1999 at Novo Palmar, Cortalim without any

Will or Gift or any other testamentary disposition of

his last wish leaving behind his moiety holder

Smt. Luisa Maria Fernandes, major in age and his

sole and universal legal heirs his children namely

(a) Mr. Francisco Fernandes, major in age,

married to Mrs. Sandra Rodrigues, major in age

(b) Mrs. Taffy Fernandes, major in age, married to

Mr. Antonio Jose Rodrigues, major in age (three)

Mrs. Eudociana Fernandes, major in age, married to

Mr. Francisco Xavier Camelo, major in age

(four) Mr. Joao Fernandes, major in age, married to

Mrs. Inacina Fernandes, major in age (five) Mr.

Antonio Fernandes, major in age, married to Mrs.

Isidora Rodrigues, major in age (six) Mrs. Ana

Joaquina Fernandes, major in age, married to

Mr. Januario Colaco, major in age and (seven) Mrs.

Pedrinha Fernandes, major in age, married to Mr.

Gustavo Ladislau Fernandes, major in age. The said

Mrs. Pedrinha Fernandes expired on 03-06-2011 at

H. No. 82, Pirni, Nagoa, Verna-Goa and her husband

Mr. Gustav Fernandes predeceased her on

08-08-1997 at Goa Medical College, Bambolim, Goa

without any issues and besides the above

mentioned legal heirs there being no one else or

any other person or persons who according to the

Law of Succession prevailing in the State of Goa,

could prefer or concur the said successors or may

have a better claim to the estate/inheritance left

by the said deceased persons.

Mormugao, 20th May, 2020.— The Special Notary

Ex Officio, Shri Kiran H. Mesta.

V. No. AP-50/2020.

Office of the Civil Registrar-cum-Sub-Registrar and

Special Notary, Salcete

___

Smt. Shobhana U. Chodankar, Joint Civil Registrar-

-cum-Sub-Registrar II and Special Notary in the

said Judicial Division of Salcete, Margao.

8. In accordance with Section 346(11) of The Goa

Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public that

by Deed of Declaration of Heirship dated 13-3-2020

duly recorded under Book No. 1676 at pages 12

reverse to 14 of the office, the following is recorded:-

That on the 5-3-2018 at House No. 1623/1,

Vasvaddo, Komlatolem, Benaulim expired Arnaldo

Do Cristo Rei Rodrigues, hailing from House No.

1623/1, Vasvaddo, Benaulim, Salcete-Goa, intestate

without executing any Will or any other disposition

of his last wish leaving behind his wife Mrs.

Candelina Arcangela Vissia Dourado alias

Candelina Arcangela Vissia Rodrigues alias Vissia

Rodrigues as his “moiety sharer” and as his “sole

and universal heir” his two daughters namely (one)

Mrs. Samantha Maria Rodrigues alias Samantha

Maria Rodrigues e Antao alias Samantha M.

Rodrigues married to Mr. Lucas George Antao and

(two) Mrs. Lisel Ann Rodrigues married to Mr. Kevin

Ovid De Souza, there being no one else or no other

person or heir who in terms of Law of Succession

in force in this State of Goa may prefer the estate

left by the deceased person.

Margao, 20th May, 2020.— The Joint Civil

Registrar-cum-Sub-Registrar II and Special Notary,

Shobhana U. Chodankar.

V. No. AP-52/2020.

_________

Smt. Shobhana U. Chodankar, Joint Civil Registrar-

-cum-Sub-Registrar II and Special Notary in the

said Judicial Division of Salcete, Margao.

9. In accordance with Section 346(11) of The Goa

Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public that

by Deed of Declaration of Heirship dated 18-3-2020

duly recorded under Book No. 1676 at pages 40 to

41 reverse of the office, the following is recorded:-

That on the 27-9-2019 at Mother Care Hospital,

Borda, Margao Goa, expired Rohidas Vaman

Vernekar alias Rohidas Vaman Vernekar alias

Rohidassa Vernencar hailing from Gogol, Margao,

Salcete-Goa, intestate without executing any Will

or any other disposition of his last wish leaving

behind his wife Mrs. Rohini Rohidas Vernekar as

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES III No. 9

28TH MAY, 2020

203

his “moiety sharer” and as his “sole and universal

heirs” his four children namely (one) Mr. Avdhut

Rohidas Vernekar married to Mrs. Deepa A. Vernekar

(two) Mr. Sandip Rohidas Vernekar married to Mrs.

Sheetal S. Vernekar (three) Mrs. Suvarna Rohidas

Vernekar alias Mrs. Priyanka Pandurang Lotlikar

married to Mr. Pandurang Yeshwant Lotlikar and

(four) Mr. Shailesh Rohidas Vernekar married to Mrs.

Prunella Pereira aias Prunella Shailesh Vernekar,

there being no one else or no other person or heir

who in terms of Law of Succession in force in this

State of Goa may prefer the estate left by the

deceased person.

Margao, 20th April, 2020.— The Joint Civil

Registrar-cum-Sub-Registrar II and Special Notary,

Shobhana U. Chodankar.

V. No. AP-53/2020.

_________

Smt. Shobhana U. Chodankar, Joint Civil Registrar-

-cum-Sub-Registrar II and Special Notary in the

said Judicial Division of Salcete, Margao.

10. In accordance with Section 346(11) of The

Goa Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public that

by Deed of Declaration of Heirship dated 20-3-2020

duly recorded under Book No. 1676 at pages 49 to

50 of the office, the following is recorded:-

That on the 28-10-2000 at House No. 20, Olvaddo,

Carmona, expired Joaquimsinho Jose Elvino

Constancio Antao alias Joaquimzinho Antao alias

Joaquimzinho Elossim Constancio Antao alias

Joaquisinho Jose Elvino Constancio Antao alias

Joaquimzinho Jose Elvino C. Antao alias Joquisinho

Jose Elvino Constancio Antao and on the 9-1-2014

at House No. 27, Carmona, Olvaddo, Salcete-Goa,

expired his wife Ofelia Maria Luis e Antao alias

Ofilia Maria Luis alias Ofelia Maria Luis alias Ofelia

Luis alias Maria Ofelia Luis, both intestate without

executing any Will or any other disposition of their

last wish, leaving behind as their “sole and universal

heirs” their six children namely (one) Mr. Arturzinho

Deucastino Santissimo Antao married to Mrs. Tulia

Alexandrina Soares (two) Mrs. Lila Premilda Antao

married to Mr. Miguel Francisco Perpetua Godinho

(three) Mr. Morgando Joaquim Antonio Antao

married to Mrs. Ursula Florinda Siqueira (four) Mr.

Pio Agostinho Inocentes Antao married to Mrs.

Felecidade de Braganca (five) Mr. Franklin Jose

Antao alias Frenklin Jose Antao married to Mrs.

Belinda Emelda Costa and (six) Mr. Selvyn Roy Jesus

Antao, bachelor who expired on the 18-6-2000 at

Grace Intensive Cardiac Care Centre opp. BPS

Clube, behind Ashro Building Margao also intestate

leaving behind his “collateral heirs” his above

brothers and sisters at Serial No. (one) to (five),

there being no one else or no other person or heir

who in terms of Law of Succession in force in this

State of Goa may prefer the estate left by the

deceased persons.

Margao, 20th April, 2020.— The Joint Civil

Registrar-cum-Sub-Registrar II and Special Notary,

Shobhana U. Chodankar.

V. No. AP-54/2020.

_________

Smt. Shobhana U. Chodankar, Joint Civil Registrar-

-cum-Sub-Registrar II and Special Notary in the

said Judicial Division of Salcete, Margao.

11. In accordance with Section 346(11) of The

Goa Succession, Special Notaries and Inventory

Proceeding Act, 2012, it is hereby made public that

by Deed of Succession dated 26-5-2020 duly recorded

under Book No. 1676 at pages 77 reverse to 78 of

the office, the following is recorded:-

That on the 10-11-1996 at Mondo, Pulvaddo,

Benaulim, Salcete-Goa expired Miguel Salvador

Rato and on the 3-6-2012 at Mondo Benaulim expired

his wife Esperanca Da Silva hailing from House No.

365, Mondo, Benaulim, Salcete-Goa both intestate

without executing any Will or any other disposition

of their last wish leaving behind as their “sole and

universal heir” their only son namely Mr. Rosario

Caetano Francisco Rato married to Mrs. Conceicao

Rebelo, there being no one else or no other person

or heir who in terms of Law of Succession in force

in this State of Goa may prefer the estate left by the

deceased persons.

Margao, 26th May, 2020.— The Joint Civil

Registrar-cum-Sub-Registrar II and Special Notary,

Shobhana U. Chodankar.

V. No. AM-14/2020.

———¿———

Office of the Civil Registrar-cum-Sub-Registrar,

Bicholim

___

Notice

12. Whereas, Mr. Sanjayajirao Rameshkantrao

Jadu, resident of H. No. 864, near MRF Banbery

Plant Tisk, Usgao, Ponda-Goa, desires to change his

name/surname from “Sanjayajirao Rameshkantrao

Jadu” to “Sanjay Rao”.

Any person having objection, if any, may file the

same in this office within thirty days from the

204

OFFICIAL GAZETTE — GOVT. OF GOA

SERIES III No. 9

28TH MAY, 2020

publication of this notice as required under

Section 3(2) of the Goa Change of Name and

Surname Act, 1990.

Bicholim, 9th March, 2020.— The Civil Registrar-

-cum-Sub-Registrar, Shri Ramdas L. Pednekar.

V. No. AP-49/2020.

———¿———

Private Advertisement

____

Affidavit-cum-Declaration

13. I, Mrs. Bilkees, daughter of Mr. Xec Mamoda

Zequeria, aged 58 years, resident of Flat No. 405/1

(BF-2), Kadar Appts., Layamati, Davorlim Masjid,

Davorlim, South Goa 403 707, do hereby solemn

affirmation and oath as under:

1. I say that I am the resident of above mentioned

address.

2. I say that I was born on 24-08-1962 and my

birth is registered in the office of Civil

Registrar-cum-Sub-Registrar of Births & Deaths,

under registration No. 1406 on 11-09-1962.

3. I say that in my birth certificate my name has

been registered therein as “Bilkees” and the

name of my father is registered therein as “Xec

Mamoda Zequeria”.

4. I say that in Pan card issued to me by the

Income Tax Department, Government of India

my name is erroneously recorded therein as

“Bilkees R Kazi” instead of “Bilkees” so also

the name of my father is wrongly recorded

therein as “Mohammed Saeed Saudagar”

______________________________

Published and Printed by the Director, Printing & Stationery

Government Printing Press,

Mahatma Gandhi Road, Panaji-Goa 403 001.

Price–Rs. 6.00

PRINTED AT GOVERNMENT PRINTING PRESS, PANAJI-GOA—60/220—5/2020.

www.goaprintingpress.gov.in

instead of “Xec Mamoda Zequeria” the same

is evident upon my birth certificate and same

needs to be corrected.

5. I say that in event of any discrepancies

occurring against the correction of names in

my Pan card I shall be hold responsible and it

may be reverted back.

6. I say that I have sworn this Affidavit-cum-

-Declaration in order to produce the same

before the Government of Printing Press to

publish the same in Official Gazette of

Government of Goa.

7. I say that I have sworn this Affidavit-cum-

-Declaration in order to produce the same

before the Income Tax Department,

Government of Goa and other Government

offices/departments in order to make the

necessary corrections in my Pan card by

deleting the aforesaid mistaken names.

8. I say that if any person brings any objections

for the above name which are to be corrected

is shall take full responsibility and revoke/

/cancel the same.

9. I say that whatever stated by me above is true

and correct to the best of my knowledge and

no part of it is false.

Solemnly affirmed at Margao on this 18th day of

May, 2020.

Sd/-,

Deponent.

Adv. Somdas K. Manjrekar,

Notary.

V. No. AP-45/2020.