ਆਪਣੀ ਜਾਣਕਾਰੀ ਭਰੋ

PART A — APPLICATION FOR PUBLICATION OF CHANGE OF NAME IN THE GAZETTE OF INDIA

To
The Controller of Publications,
Department of Publication,
Government of India.
(Filed online at egazette.gov.in, or by post to the Department's office, whose current address that portal publishes.)

Subject: Application for publication of change of name in the Gazette of India

Sir/Madam,

I enclose with this application:
(a) my affidavit affirming the change of name, sworn before a Notary Public / Oath Commissioner, set out at Part B below;
(b) proof of my identity and address in my present name;
(c) the newspaper cutting(s), or e-paper printout, of the advertisement of this change published as set out at Part C below;
(d) the fee prescribed by the Department, as applicable on the date of this application.

I request that the notification be published at the earliest.

Yours faithfully,

PART B — ANNEXURE I: AFFIDAVIT

I, __________, __________ __________, aged __________ years, resident of __________, do hereby solemnly affirm and declare as under:

1. 4. That I have no objection to this change being published in the Gazette of India and in the newspapers named at Part C below.

VERIFICATION

DEPONENT
__________

Signature: ______________________________

NOTARY PUBLIC / OATH COMMISSIONER
Name: ______________________________
Registration No.: ______________________________
Seal and Signature: ______________________________

PART C — ANNEXURE II: TEXT FOR NEWSPAPER ADVERTISEMENT

PUBLIC NOTICE