CHECKLIST BEFORE FINAL SUBMISSION
NOTICE FOR SOLEMNISATION OF MARRIAGE
The Special Marriage Act, 1954 (Under Section 13)
DRAFT NOTICE NO.: D2025-0502174673 DETAILS OF GROOM
Full Name AMRESH KUMAR
Father's Name KALESHWAR SHAW
Mother's Name SUSHILA DEVI
Date of Birth 02-03-1995
Religion HINDUISM
Mobile Number 8100137133
E-mail ID panchatsaran.sales@gmail.com
Aadhaar Number 469246261452
Occupation SERVICE
Present Address S/O KALESHWAR SAW, GARSANDA, VILLAGE-
LAKHISARAI, GP- AURA, BLOCK- RAMGARH CHOK, PO-
KACHHIYANA,PS- RAMGADH CHOK, DIST-
LAKHISARAI,BIHAR, INDIA, PIN- 811107
Permanent Address S/O KALESHWAR SAW, GARSANDA, VILLAGE-
LAKHISARAI, GP- AURA, BLOCK- RAMGARH CHOK,PO-
KACHHIYANA,PS- RAMGADH CHOK, DIST- LAKHISARAI,
BIHAR, INDIA, PIN- 811107
Marital Status UNMARRIED DETAILS OF BRIDE
Full Name KAJAL SHAW
Father's Name RAJU SHAW
Mother's Name BABY SHAW
Date of Birth 02-01-1999
Religion HINDUISM
Mobile Number 8100281837
E-mail ID amitshaw9123@gmail.com
Aadhaar Number 376174856790
Occupation STUDENT
Present Address D/O RAJU SHAW, 21D TAGORE PARK, TILJALA, SOUTH 24
PARGANAS, DIST- KOLKATA, PO- TILJALA, PS- KASBA,
WEST BENGAL, INDIA, PIN- 700039
Permanent Address D/O RAJU SHAW, 21D TAGORE PARK, TILJALA, SOUTH 24
PARGANAS, DIST- KOLKATA, PO- TILJALA, PS- KASBA,
WEST BENGAL, INDIA, PIN- 700039
Marital Status UNMARRIED DETAILS OF MARRIAGE OFFICER
Name PURNIMA DAS INDU
Contact Number 9433449539
Office Address 15/2 JAGANNATH GHOSH ROAD,SUBDIV-KOLKATA,PO-KASBA,PIN-700042,DIST-
KOLKATA
Jurisdiction BALLYGUNGE PS, KASBA PS, PURBA JADAVPUR PS, TILJALA PS
DETAILS OF REGISTRATION
Proposed Registration Location 15/2 JAGANNATH GHOSH ROAD, PS- KASBA, PO- KASBA, PIN- 700042, DIST- KOLKATA,
WEST BENGAL
Proposed Registration Date 10-03-2025
DISCLAIMER
This is an abstract of application made by the groom and bride do not ratify solemnisation of their marriage.
Recorded Signature of Marriage Officer Signature of Marriage Officer with Date
Generated from https://rgmwb.gov.in on 05-02-2025 06:54 PM Initial Submission Page 1 of 2
Applicable for Application under Marriage Act 1954
Schedule of Signature A
We hereby give you Notice under section-5 that a marriage under Section 13 of the Special Marriage Act 1954 is
intended to be solemnized between us within three (3) calender months from the date of notice. Particular are furnished
as above.
বিশেষ বিিাহ আইন ১৯৫৪ এর ১৩ ারা শ আ া ব ন াশসর শ আ রা আ াশ র বিিাহ স রার
শ শে াশি আইশনর ৫ ন ারা শ এই বি ব াবর রব আ াশ র ি ব িব শর
িব হশ
Applicants LTI & Signature/if illiterate RTI Date of Signature
KAJAL SHAW
(Bride)
( শন)
AMRESH KUMAR
(Groom)
(ির)
Generated from https://rgmwb.gov.in on 05-02-2025 06:54 PM Initial Submission Page 2 of 2
