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In the Court of the Ld. Judicial Magistrate, 1st Class, Sealdah Court.

AFFIDAVIT
I, Sandip Kumar Gupta, S/o Belvadra Shaw, by Faith- Hindu, by occupation-
business, residing at 5B/14, Seals Garden Lane, Cossipore, P.O.+ P.S.-
Cossipore, Kolkata -700002 do hereby solemnly affirm and declare as
follows:-
(2)
1. That I am citizen of India.
2. That I am residing at above mention address.
3. That my actual name is Sandip Kumar Gupta.
4. That my actual Sandip Kumar Gupta is recorded in Adhar card vide
adhar card no. 3750 2146 2809.
5. That my actual name Sandip Kumar Gupta is also recorded in Pan
card vide Pan no. AIVPG0989K.
6. That by mistake my name is recorded as Sandip Gupta in my daughter
Astha Gupta birth certificate vide birth certificate no. 0128610 in
place of Sandip Kumar Gupta.
7. That Sandip Gupta S/o Belvadra Shaw and Sandip Kumar Gupta S/o
Belvadra Shaw is same and identical person.
8. That I am swearing this affidavit to prove that my actual name is
Sandip Kumar Gupta S/o Belvadra Shaw and it should be recorded in
my daughter Astha Gupta birth certicate.
The above statements are true to the best of my knowledge and belief.

-------------------------------
Declarant
Identified by me

Advocate

Solemnly affirmed before me by the


Declarant who is identified by……...
……………., Advocate on………….
At Alipore Court

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1st Class Judicial Magistrate

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