A F F I D A V I T

(FOR DATE OF BIRTH)

I, Smt. Rekha Majumder, wife of Sri Ratan Majumder, aged
about 29 years, by Faith Hindu, by Nationality Indian, by Profession
Housewife resently residing at!" Md# $# %# Road, Purban&hal,
'lo&("), P# *# +holaba,ar, P# S# +hola, )istri&t 2- Parganas .N/,
Pin 011222, do hereby solemnly affirm on oath and de&lare as
follows!"
%ontd332

"2"
2# 4hat I am a bonafide &iti,en of India and ha5e been residing at the
abo5e mentioned 6ddress#
2# 4hat my arents inform me that I was born on 7
th
)e&ember, 2989
.17:22:2989/, at my arental home#
;# 4hat I ossess one '# P# <# Ration %ard .No# 1801078=
Folio No# 8917"10= F# P# S# No# 802/ duly issued by the Rationing
*ffi&er, Panihati, 2- Parganas .N/, dated 27"22"2110, on behalf of the
+o5ernment of >est 'engal, as the roof of my Identity#
-# 4hat my 5oter Identity &ard bearing no ?>N 2729898, issued
by the @le&tion %ommission of India, is the another roof of my
Identity
4he statements made in the abo5e aragrahs of this affida5it are true to
the best of my (nowledge and belief#
""""""""""""""""""""""""""""""""""
.) @ * P N @ N 4/
Solemnly affirm before me and Signed before me and
by the )eonent, who is identified identified by me
by Sri San(arnath %ha(raborty, 6d5o&ate
on this day# 6d5o&ate

Audi&ial Magistrate, First &lass