ANNEXURE ‘A’

I, SHRIDHAR SHETTY S/o RAGHURAM SHETTY presently residing at

Shabari Darshini, Srinagar, Haliyal Road, Dharwad-580003,

KARNATAKA hereby state the following:

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I, was born on 16-01-1967 at Kukkehalli situated in the district Udupi in the

State of Karnataka. I have no documentary proof in support of my place and
date of birth.
I do not possess any educational qualification and I am an illiterate person.
I take oath and solemnly declare/affirm that the particulars furnished by me
above are correct and that I have not concealed or misrepresented any facts.
I have learn to sign.

Place : Dharwad
Date: 10-11-2011 DEPONENT

Verified on this 10th day of November of the year 2011 that the contents of my
above affidavit are true and correct to the best of my knowledge and belief, and
nothing in material has been concealed there from.
The contents of the affidavit have been read out to me.

Date: 10-11-2011
Place: DHARWAD DEPONENT

I known deponent

(J.S. Golandaj)
Advocate, Dharwad