AFFIDAVIT

I, Mr. /Mrs _____________________ Son/Daughter/of ______________________

age _______ years, an adult, Indian inhabitant, residing at_______________________
______________________________________________________________________
______________________________________________________________________
Do herby state and declare on solemn affirmation as under.-

state

and

declare

that

my

name

is

Mr/Mrs_________________S/D/O

_________________________, which is mentioned in the aadhar card bearing

number.__________________________

state

and

declare

that

my

name

is

Mr/Mrs_________________S/D/O

_________________________, which is mentioned in the pan card bearing

number.__________________________
(Passport/election card/driving license etc... this are the example you may put one proof
is also enough)

I state and declare that my name/surname/father name/mother name etc. is mentioned

wrongly as wrong printed name here in the mark sheet of the 12 th standard issued by
state board/university etc. Bearing mark sheet serial no._________ issued in the year
___________

I state and declare that my name/surname/father name/mother name Mr/Mrs your

original name here and Mr/Mrs. Wrong printed name here is the one and the same
person i.e.my self(incase of your personal name)

I am making this affidavit, to submit before the concern authority to show said facts and
record my name/surname/father name/mother name etc. as your original name here

Whatever stated herein above is true and correct to the best of my knowledge & belief
and if the contents of this affidavit shall be prove false then I alone shall liable for the
punishment U/S 199,200 of I.P.C.

Solemnly affirmed at Mumbai/pune etc )

On this 1st day of May, 2016

Deponent

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The affidavit has to be printed in 100 Rs. stamp paper

1st page should be printed in on stamp paper itself
2nd page should be printed in legal paper
Attached the photocopy document in which name is correct
Get it done notarized from the notary person
THANKS