au 2m H@onpfl/ Self Declaration A@asress ora, yssod9 aiid, swemburssid Agmod / web, SHYAMSYESGEEYE aga stoi orgqii@iubd Crn® Asqsild adloGb Aedes Coraficy 2 singer Guus Sy 2 Carder aliens sySw pret, crerenned AUpHSIULL geadacr snonsgib grox Sis aimsde einen cenab,rbs BSAdK EH ciéroaTs weensauLcldrens stenajd, Grex sefl5s Sealcdecir/ Aasenisss eines Ypdumererai cron Verornohe AsfuagGid uso, Oss seim_merés Lib 177 womb 199-e Sp corde oHors oKSuron pL aigsons CoHAsncreriuGid crorung sain roxy sumenCanG 2 pyHuoiéslerCer. | am Selvan Monish U son of Thiru U Venkata Subbaiah residing at Door No. SHYAMSYESGEEYE , street of Rajangkuppam Road Village / town of Ayanambakkam, Taluk of Poonamallee, Tiruvallur District, Tamil Nadu State. The details furnished by me are true to the best of my knowledge and believe and nothing has been concealed herein. | declare that | am well aware of the fact that if the information and documents given by me are proved to be incorrect / not true in future, | shall be liable for prosecution under section 177 & 199 of the Indian Penal Code. Signature of the Applicant / wgyeroiér exQuiniusd