AFEIUAVI 1, Smti, 2 az, aged about 25 yrs, W/O, Shyamal Dhar, resident of Vill, Jatkapan, PO. Lalarchak, PS. 4 Dist.- Karimganj, Assam, by faith: Hind, by Nationality= indian, do hereby solom firm & declare as follows 1- 1) That I am a Citizen of India by birth & pormanent resident of above stated address, 2) That 1 was born at Bhairyb Lane, Silchar Road, Ward No.27, ¥O, Silchar Koad, PS, & Dist. Karimganj, My parents are Tapan Chandra Mazumdar & Jyotl Mazumdar. 3) That 1 was born in a family of ‘Mazumdar! Community of Hindu & married to a person of 'Dnart Community of Hindu, According to Hindu religion, wife's title accorded to her husband's title. so, my title naturally changed after my marriage as 1 am a family member of my husband. My marriage solemonised on 9th December,2016. And since then I have been living at my husband's family, My husband, Shyamal Dhar is the S/O, Lt. Mohanlal Dhar Smti, Bibha Rani Dhar, of vill, Jatkapan,under Jatkapan - Barkatpur G,P, 4) 1 declare by this affidavit that, 'Jhama Hani Mazumdar Jnarna Hani Dhar, both name(s) are of myself, before and ‘after marriage, though I am a same & single lady/woman. This is true to my knowledge & belief, @ a 5) That this affidavit 1s sworn to proof the above facts & Produce before concern authority for change of my title 4 also for identification of myself. And enlist y, name in the Voter List of my husband's oy Spa a Share family. ore D Thar ne Rom Mazand at nie anc iv i h ANON. WHY SA ASSAM 12AA 348602 ( Page No. 2) That the statement stated above are true to the best of my knowledge & belief and 1 put my signature hereunder on this 7th November, 2017 at Karimgan} Court. Identified by me, | hear te Rava Dor 2 Darcie Rant Maz aida soe (Signature of Deponent ) Karimgal urt. SWORN BEFORE ME whe Udvece: ser) ba ibs MY BGs RNO-235i85 70 (dooass Layha Lay My MAGIS rARY Addi. Dy tet Ma, Kainygagye 00 &