au 2m H@onpfl/ Self Declaration Ses wren Lid, SLeps aLid, umm Spm / wand, 4/56 sa) croio LUILYOTQUTUE Aswad adeeb De uroP simpler Guus So AawiiIgocfiue 8 gre, ceronnd aphslUuLL geacdadr senensgd ror SIDS aimaild eeironn cera, Seadsen crerertd enpssieslcrensd cere, Kren 65s SeacdEcr/ soonTiiscr 2 cineninkG YMbuTETAEI ste Gerernofe Agfuagis uss5d, Q¥su sermons sit 177 wind 199-er Sip cords HOTS LF Hurer pasos CopGencreniuGid srericng silGasr sre) suBererCam® 2 psuohsdentper. lam Thiru Bharathi son of Thiru Sivasubramanian residing at Door No. 4/56, street of Pappurediyapatti Village / town of Pappayampadi, Taluk of Kadavur, Karur 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, I shall be liable for prosecution under section 177 & 199 of the Indian Penal Code. Signature of the Applicant / wgyeroiér exQuiniusd