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A21476 20151/00090

f. i. C122/20151/0097
0803521 Regn.No,

CENTRAL BOARD OF SECONDARY EDUCATION

MARKS STATEMENT CUM CERTIFICATE

HIfAR faatY vrT, 2022
SECONDARY SCHOOL EXAMINATION, 2022

This is to certify that MUKUL

Roll No. 13214146

Mother's Name REETA DEVI

Father 's / Guardian's Name HARDIP SINGH

Daie of Birth 07-40-2005 7THOCTOBER TWO THOUSAND FIVE

faarT
School 20151 - SRIGURU HARKRISHAN PUB SCHOOL PATHANKOT PUNJAB
1îafre verfat frgR Ëbas achieved Scholastic Achievements as under :
WTHT# MARKS OBTAINED

SUB. ferfga
CODE
SUBJECT (ai ) POSITIONAL
GRADE
THEORY WT. PR. TOTAL TOTAL (N WORDS)
184 ENGLISH LNG & LIT. 049 017 066 SIXTY SIX C2

085 HINDICOURSE-B 055 016 071 SEVENTY ONE C2

041 MATHEMATICS STANDARD 043 017 060 SIXTY C1

086 SCIENCE 041 018 059 FIFTY NINE C1

087 SOCIAL sCIENCE 065 017 082 EIGHTY TWO B1

ADDITIONAL SUBJECT
402 INFORMATION TECHNOLOGY 028 048 076 SEVENTY SIX B2
004 PUNJABI 057 017 074 SEVENTY FOUR C2

qiA Resut PASS

frrl Deihi
fTE Dated : 22-07-2022 Controller of Examinations
E-Stamp Cert. No. IN-PB95595875933853X Dated 08.01.2025 for Rs.50/
AFFIDAVIT
I, Mukul S/o Shri Hardip Singh resident of Village Ranipur Upperla, PO:
Shahpurkandi, Tehsil & District, Pathankot, Punjat, India, do hereby solemly
affirm and declare as under :
1. That presently my name is Mukul and the same name is recorded in my
alldocuments.
2. That our surname is Thakur' and my surname is not included with my
name in any of my document.
3. That I want to include my surname Thakur' with my name as Mukul
Thakur.

4. That hence-forth Ishall be known by my name Mukul Thakur and shall

use my name Mukul Thakur for my all documentary work.
5. That my above statement is true and correct.

Deponent:
Verified that the contents of my above affiuavit are true and correct to
the best of my knowledge and belief and nothing has been concealed therein.
Deponent: Thakur
 1302 15 Government of india

Aino.saduheadr: Mukul Thakur

RM fDOB: 07/10/2005
Mde MALE

Aadhaar is proof of identity, not of citizenship

or date of birth. It should be used with verilcation (online
authentication, or scanning of QR code /ofline XML).

39106582 2403

Unique ldentification Authority of lndia

09/o4205
éHH- 145029
on:
8 Address:
S/O: Hardip Singh, vill ranipur upperla, Shahpur, PO:
Detais Shahpur
as
Kandi, DIST: Pathankot,
Punjab -145029

3910 6582 2403

VID:9128 9093 3447 1224
1947 9 helpauidai.gov.An www.uidai.gov.in
718 [PART IV
1946)
THE
GAZETTE OF INDIA, FEBRUARY 22, 2025 (PHALGUNA 3,
I hitherto MULEWA S/oBABU
Slo JAWAHAR LAL known as HARBANS CHAWLA hitherto
I known as RAJENDRA
Binjwadia
MULEWA,R/o 33, Bera
Bader Ka Bhadrwa
CHAWLA,
Gurgaon, Haryana-122001, have R/o 49-50/9, Shiv Purl, LAL
Jodhpur, Rajasthan-342602, have
Bilara,
hereafter be known as HARBANS changed
LAL. my
name and shall Road, Bcenjwariya,
name and shall
hercafter be known as
changcd my
RAJENDRA CIHOUDHARY.
It is certified that Ihave
requiremcnts in this connection.complied with other legal It is certified that I have
complied with other legal
requirements in this connection.
HARBANS CHAWLA RAJENDRA MULEWA
[Signature (in existing old name)]
(Signature (inexisting old name)]

Ihitherto known as MUKUL S/o HARDIP

SINGH, S/o ANNUP
residing at Vill-Ranipur Upperla, Shalhpur, PO-Shahpur Kandi, Ihitherto known as SOURAV AGARWAL
Distt. Pathankot, Punjab-145029, have changed my name PARTHIV AGARWAAL, R/o 270, Raja Ram Mohan Roy
and shall hereafter be knowm as MUKUL THAKUR. Road, Pashchim Putiari, Kolkata, West Bengal-700041, have
known as SOURAV
changed my name and shall hercafter be
It is certified that I have complied with other legal GOVINDYASHWANTH AGARWAL.
requirements in this connection.
It is certified that Ihave complicd with other legal
MUKUL requirements in this connection.
(Signature (in existing old name)) SOURAV AGARWAL
[Signature (in existing old name)]
I hitherto known as BALWANT PRATAP SINGH
Slo BINAY SINGH, residing at Village-Bhadwa Dih, PO Ihitherto known as JIWAN MITTAL S/o Lt. UDAIRAM
Bhadwa Bazar, PS-Rafiganj, Distt. Aurangabad, Bihar-824122,
have changed my name and shall hereafter be known as DABRIWAL, residing at Upper M.G. Marg, Balchand
DEEPAK KUMAR. Udairam, Gangtok Municipal Corporation, Gangtok, East,
Sikkim-737101, have changed my name and shall hereafter
It is certified that I have complied with other legal be known as JIWAN DABRIWAL,
requirements in this connection.
It is certified that I have complied with other legal
BALWANT PRATAP SINGH requirements in this connection.
[Signature (in existing old name)] JIWAN MITTAL
(Signature (in existing old name)]
I hitherto known as SHAILENDRA RAHEJA
Slo GURMUKH DAS, residing at 68, Lohar Bagh, Sitapur, Ihitherto known as RITA RANI W/o ASHOK KUMAR,
Uttar Pradesh-26 1001, have changed my name and shall residing at House No. 202, Ward Number-4, Mall Godown
RAHWANI.
hereafter be knowm as SHAILENDRAKUMAR Road, Dhuri, Sangrur, Punjab-148024, have changed my name
'A BA
 fHHCdH3 SHd Registrabon No BUESOS074267207 Document Sr. No: ES23198230
Oid Regst ahon Number iox reference3730

ug HJaraiGovemment of Punjab
fra3 3ufserJ BHÉ fega Heath and Family Welfare Department
te afHCGT HSH 3 , /Chlef Registrar (Birth &Death), Punjab
H5H E Jtfetz I Birth Certifncate

TOHIForm -6

vS8Z. 3fâg vsdz.f VJsaz,Tg, 2005 afHZa fee edrdi

This is to certity that following information has been taken from the original birth record which is registered in the birth register of Local
Registrar., Birth &Death, Municpal Corporaion Pathenkot, Tehsil Pathenkot, District Pathankot of Punjab State for the year 2005.
5H IName: Ha# Sad/MUKUL THAKUR
fai /Sex: VJH I Male
fug H/ Father's Name: Jty f I HARDIP SINGH
/Grand Father's Name: ados fAYIKARNAIL SINGH
H3H/ Mother's Name: asr 2a/REETA DEVI
HH fâ Date Ot Birth: 07/10/2005 HOH T HSPlace of Birth
sfHCGHS ã fH IDate of Registration: 07/10/2005 yd IHM36, 46GdZIKAPOOR HOSPITAL, PATHANKOT

Address of Parents at the time of birth of the child Permanent Address of Parents

VILL RANIPUR UPPERLA PATHANKOT VILL RANIPUR UPPERLA PATHANKOT

Note:- Issued w's 17 of the Registration of Births and Deaths Act, 1969 and rules 13 the Punjab Registration of Births and Deaths Rules 2004.

Remarks:Haafztz fsaJI NSHT à

Signature of the Issuing Authonty:
Digitaliy Signed by: SUMAN KUMAR

Designation: EOMC

Location: MUNICIPAL CORPORATION

PATHANKOT
Date and Time of Signing: 16/O4/2025
1. Tho authenticity of this document can be verified using document serial number at the web link 'https/essewa punjab Qov in ceuthateVenicabon'
or by scanning OR code. Any discrepancy in details on this docurnent as cormpared lo those available on the veriñcabon web link renders this
document invalid.
2 This is a digitally signed certificale and doesn't require physical signature, or hologram, or stamp as per Punjab Government Nobhcabon no.
E122499/GRICI172 Dated. 31-08-2022, availYbie at 'htpsilouniab.gov in'
3 The resposibiity of venification of this document before acoeping the same for any legal puposes would rest with the Insiuion /Org•nizabon.
Company or any other Entity where this document is produced.
This certifcate is valid as per Iníormation Technology Act 2000 as amended from time to ime.
5 in case of any disaepancy. please inform the issuing authority about the disCrepancy in the cer tificate.
meeta
Print Date 16/042025

Signature valid
Digitally signed by OMAN KUMAR
Date: 2025.04Nb 42:17 +05:30
Reason: DigtallySigned
 the pioneer
DIGARH |THURSDAY I JANUARY 9, 2025
02

ANDFOUND
ljeet Singh Ral Slo
I, Mosam 5/5 PSI S/o
Sh. Sube Singh R/o EF-2,
1st Floor, TDI Espania, Near
, Sumitra W/o Krishna
Kumar R/o Chhapar Teh, and
Distt. Charkhi Dadri 127306
Classifieds
1. Akul
Divanshu
Mahajan Alias
MahajanSlo
I, Chandrawati
Mother of No, 15573627X
is I, Harvinder Slo Vijender Sangeeta alias , Govindarajan Father
Singh Rai Rlo Vill: Late.Anil Mahajan, Singh R/o 408 Supermax Shakuntta WIO Sunil Kumar of No.17016629N CEN
Jurasik Park, Sonipat, declare that My son Amit Rlo Rank HAV Name Jitendra Society, Near Huda Stadium,
Teh-Balachaur (SBS Golden Avenue Saili Road RIO 286 Sundar Nagar Vishnudas G resident of
declare that m Haryana declares that Kumar service No Pathankot Have Changed My Kumar Singh, Unit 104 Sec-33, Sonipat have Mandour Ambala city Distt
Mosam & Mosam Khatri both 17001373Y and in my son Name From Akul Mahajan ENGR XEGT and changed my name to Village- Elappuliy. Post
tion certificate Ambala have changed my Pallatheri, Tehsil- Paiakkad
year 2012-2013, are my names. In future, I service record my name Alias Divanshu Mahajan Permanent resident of Deen Harvinder Rathee for all name To Shakuntla
Divanshu Mahajan, For toAll Burhasi,
shall be known as Mosam. written as Sumitra Devi and Dayal Pur Budhansi, future purposes District- Palakkad, State
oard Index No. I, Rajesh S/O Dev Singh Kerala, Pin-678007, have
m6 March-April 2013 I, Suman Lathar W/o my DOB is 5.8.1967 which is
Pupose. Aligarh, Koil, Uttar I, No.-6495144K Rank R/O 304 Vill Baknour Distt changed my name from
lost in my home. If Sh. Yjunder Singh Kadian, wrong. my Correct Name is Pradesh 202125, have
en contact at my R/o H.No. 4873, Sector 11, Sumitra and Correct DOB is TMukul S/o Hardip changed my Name from
HAV Name Badgujar Gulab Ambala have changed my Govindarajan to
7.4.1966 Singh, R/o Village Ranipur Chanderwati To Bhagwan R/o Vill. & PO Minor Son name from Aditya Govindarajan B M Vide
ress. Extn., Jind (Haryana) have Upperla, PO Shahpurkandi, Devlali Camp, Teh. Devlali Kumar to Aditya Anttal affidavit
changed my name from , Manvinder Singh Chandrawati, and changed No.IN
Tehsil & District Pathankot my Date of Birth from 10-06 Camp, Distt. Nashik,
HALINOTICE Suman Lathar to Suman Wadhawan S/o Jaswant
(Punjab), Declare That My Maharashtra-422401 have I, Rajesh Kumar S/O PB95484765851078X
Lata. Singh R/o # 2115, Sec-17, 1947 TO 01-01-1954, Vide Dev Singh RIO 304 Vill dated 08 Jan 2025 before
Parkash Ahuja S/ Name is Mukul and Surname Affidavit No. IN changed the name of my son Baknour Distt Ambala have notary public Pathankot
Huda, Jagadhri, Distt is Thakur,
an Chand HNo. , Anupam Dubey Slo Now in Future I PB95668798647 158X, in army record from Rohit to
or 25 Panchkula Shiv Shankar Dubey R/o Yamunanagar have Changed Shall Use My Name Mukul Dated 08-01-2025, Before Rohit Gulab Badgujar vide changed my name to Rajesh. I, Shylaja Mother of
eclare That My House no 421/1, vishal my name from Manvinder Thakur, Kindly Note. ) Distt. Court, Amritsar. affidavit dated 08-01-2025 I, Gopal Krishan Slo No. 17016629N CFN
Singh to Manvinder Singh Shyam Sunder R/o Ward Vishnudas G resident of
Bharat Ahuja And nagar, Jagadhri, Yamuna I, Kamal Dev S/o Bal before Session Court Hisar.
Wadhawan. Gunjan D/o Sh No.10, Khede Wali Gali, Village- Elappuily. Post
nivani Ahuja Are Nagar have changed my L Sudarshan Kumar Slo Krishan Sharma # 90, Sector Sandeep Goyal R/o H.No. , Durga Wife of No.
y Control We minor son's name from 49-A. Chandigarh have 6495144K Rank HAV Name Pehowa, Kurukshetra have Pallatheri, Tehsil- Palakkad.
Ram Chander Rlo 1942. 409 B, Gali NathuThanedar District- Palakkad, State
hem From My Ruhänsh Dubey to Aman changed my name to Kamal Wali, Subhash Chowk, Sirsa Badgujar Gulab Bhagwan changed my name Gopal
Sector 2 Part, Rohtak declare Kreshan. Kerala. Pin-678007. have
Immovable Dubey. that Sudarshan Kumar Slo Dev Sharma. (Haryana). That have Rlo Vill. &PO Devlali Camp,
y Body Dealing I, Sanjay kumar Slo changed my name from Teh. Devlali Camp, Distt. I, Sarbjit Kaur Wlo changed my name from
Ram Chander and Sudrashan 1, Rajesh S/o Krishan Shylaja to V Sailaja Vide
At Their Own Vishwanath prasad R/o Kumar Dahiya S/o Ram Chand M.D.A.V. School, Gunjan to Gunjan Goyal , in Nashik, Maharashtra-422401 Kushbir Singh Rlo Village
Hardo Sangha, Po. Kot affidavit No. IN
House no 1729 Vishnu Chander Dahiya both are the Sector 22-A, Chandigarh future my name is to be have changed my name in
garden, chotti line Jagadhri, called as Gunjan Goyal. Badal Khan, Tehsil Phillaur, PB95483929750268X
Slo Nura R/o name of one and same have changed my name to army record from Durga to dated 08 Jan 2025 before
liNo. 2, Pragati Yamuna Nagar have person. Rajesh Mehra. Durga Gulab Badgujar vide Dist. Jalandhar-144039,
I, Nand Kishore Singh is notary public Pathankot
Area-Ward-31. changed my minor son's affidavit dated 08-01-2025 Punjab have delete the
I, Amrit Kaur W/o I, hitherto known as Ram legally Father of of No.
SOWned my son name from Kislay kumar to Satvinder Pal Singh Multani Surat Son of Ram Sanehi 15728843H Rank NK Name before Session Court Hisar. surname of my minor I, No.17016629N CFN
y all movable Sharvil kumar. Rlo Q-242 Vishal Kumar Shandilya of daughter Jasnoor Kaur Vishnudas G resident of
Army Flats, residing at H.No.26, Bhakhri I, 14653158X Rank HAV Chandi to Jasnoor Kaur.
perty as he is I, Saurabh Gupta S/o Sector-4, Mansa Devi Nidura, Suttanpur, Utar Unit 7 Inf Div Sig Regt Clo 56 Name Kumar Chhetri R/o Village- Elappully Post
ol. In future, if Vijay Gupta R/o 1041/2 Complex, Panchkula-134114 Pradesh-227806 APO Residing at Ward No.6, I, Nanak Ram Dass Slo Pallatheri, Tehsil- Palakkad.
have Vill. Moktan Goan (Ward No
s with him, Anand Colony, Gobindpuri, (Haryana) have changed my changed my name and Shall Dharamraj Tola, Barahiya., 14), PO Kalimpong. Teh. Avtar Singh Rlo Vill. Balra. District- Palakkad. State
at their own Near Gaba Hospital, name to Amrit Multani. hereafter be known as Ram Lakhisarai, State Bihar Pin Kalimpong, Distt. Darjeeling. Tehsil Dasuya, Kerala, Pin-678007. have
Jagadhri, Yamuna Nagar I, Rohit Slo Victor Kumar Surat Gautam 811302 Declare That my West Bengal-734301 have' Distt.Hoshiarpur, Punjab changed my Son name from
ISingh, Slo have changed my minor R/o VPO Sahri Distt. I, hitherto known as Uma Name Nandkishore Prasad
changed the name of my have changed my name from Abhinav VR to Abhinav VR
R/o # 125, daughter's name from Sarah Hoshiarpur Punjab have daughter of Ram Gopal wife Singh and Date of Birth daughter in army record from Nanak Ram Dass to Nanak Vide afidavit No IN
Rorian, Ward Gupta to Sara Gupta. changed my name from Rohit of Girish Ahuja residing at 10.03.1960 Wrongly Nikisha to Nikisha Chhetri Singh. P895481228393913X
Tehsil Payal, I, Chhavi Uboweja D/o to Rohit Kumar. H.No.655, Basant Avenue, Mentioned in my Son Army vide affidavit dated 08-01 I, Avtar Ram Dass S/o dated 08 Jan 2025 before
Amritsar-143001 Punjab have Service Records but my 2025 before Session Court Binda Singh R/o Vill. Balra, notary public Pathankot
a, Punjab, Smt. Nisha Rani and Sh. Anil I, No. 13755440A Ex Hav
correct Name is Nand
/ daughter Mendiratta R/o House No. Santosh Kumar Slo Rulia changed my name and shall Hisar. Tehsil Dasuya, Distt. I, Chanchal Devi Wife
Divorced) is Ram Rlo Vill. Rally, PO hereafter be known as Uma Kishore Singh and Date of
1078, Sector 18 C Birth is 01.01.1954. I, Kanhiya Anand S/o Hoshiarpur, Punjab have of No. 14684 179P NK
pui
sil
kad
00
ame
aja

b
fafaer
Ic0Er, árR,9 14aa, 2025
11
IBebby is legally Mother of
No. Urmila Devi residing at Vill korbaddha pateli
Rank Sigmn Name Tomar Rahul15748381H , Jashandeep Kaur D/0 Surjit Singh R/O VPO
Unit 7 Inf Div Sig Regt C/o 56 APO Singh of Nangal Tehsil and Distt. Pathankot have ,Pataili Distt Samastipur (8ihar) have changed
my date of birth 01.07. 1963 to 01.01.1959 vide
at Village Sikandarpur, Patara, Residing changed my name from Jashandeep Kaur to
afidavt date 08.01..2025 before notary public
CH ALIAS DAVINDER KUMAR State Uttar Pradesh Mainpuri, Jashan Deep Kaur. Concerned note please
Pin-205268 Distt.Court Bathinda (PB)..
CH RESIDING AT H.NO38, SAI That my Name Tomar Baby Devi and Declare (4202)
SEICERS COLONY TEH, DIS Birth 03.02.1966 WNrongly Date of IAmít kumar residing Vil korbaddha pateli
Mentioned in my , DALJIT KAUR Spouse of No 13856030-L Ex
PUNJAB- 147001 have Son Army Service Records but Sep Prem Singh resident of H. No 3446, 8 ,Pataili Distt Samastipur (Bihar) have changed
eto DAVINDER my
KUMAR. Name is Bebby and Date of correct Block-12, Manmohan Nagar, Ambala City, My Son nàame Master Adarsh Raj to Adarsh Raj
Birth is Vide affidavit date 08.01.2025 before notáry
(4978) 03.02.1970. Distt - Ambala (Haryana) have changed my
Son of name from DALUIT KAUR to DALJEET KAUR public Distt Court Bathinda (PB)..
No.15370626ASep IArmy No. 15333468Y Rank Hav Name
yPO-Burj Dhillwan District Jayavant Ravindra Patil of Unit 22 Engr and DOB from 10 JUL 1960 to 15 FEB 1960 I Tarunkumar Yadav residing at vill. Lucknow
ve changed my name C/o 56 APO Ferozepur Declare Regt, vide affidavit dated 08.01.2025 before Distt. Lucknow (Uttar Pradesh). have changed
to That my
nd date of birth corrected Ambala Cantt (4644) my minor Doughter name Ojasvi Yadav to
Name Patil Jayavant R Kumar Wrongly
o 11-03-1993 Mentioned in my Army Service Records but I NO-TJ-6527L SUB SEWA SINGH UNIT- 126 inf Ojasvi Yadav vide affidavit date 08.01.2025
before notary public Distt.court
oBaldev Raj R/o # 3419, my correct Name is Jayavant Ravindra
Patil. Bn TA JAK RIF C/O 56 APO RESIDENT OF VIL
Mohali have changed my I, No. 3002879N, Rank HAV, Name LAGE KATLI. TEHSIL-DINGA Amb District Bathinda(PB)..
to Kanhiya Anand Dhruv KATHUA (J&K) Pin no, - 184144 DECLARE IOmana Janardhanan residing at vill kanchiyar
Kumar Unit of 17 Rajput C/o 56 APO,
THAT IN MY SERVICE RECORDS MY MOTHER Distt ldukki (kerala ) have changed my name
av S/o Jagat Singh, vill Resident at Amby Nagar Colony, Opp NAME AND DATE OF BIRTH WRONGLY MEN Omana Janardhanan to Omana and date of
a, Rajasthan-301713 Talspur Gate, Ramghat Road, Aligarh, (UP) TIONED AS VIDIYA DEVI AND 01/06/1941 birth 01.07.1962 to 01.01.1964 vide affidavit
ervice record mny wife Pin-202001 have changed my Daughter date 08.01.1964 before notary public
BUT HER CORRECT NAME IS VIDHYA DEVI
mich is wrong but her name From KUMARI PRATAH to PRATHA
m Kumari as per her AND DATE OF BIRTH IS 1607/1933 VIDE AFFI Distt.Court Bathinda (PB). (4991)
Vide Affidavit Dated 08 January 2025 before DAVIT BEFORE NOTARY SATPAL PATHANKOT.
wit dated 18.09.2024 I, No. 13755440A Ex Hav Santosh Kumar S/o
at Executive Magistrate Ferozepur. PUNJAB Rulia Ram R/o Vill. Rally, PO Daggan Tehsil
B/o Jagat Singh, Vil I, BATERI DEVI is legally Mother of Name Dasuya Distt. Hoshiarpur Punjab have changed
INO--10363278M HAV BALBIR SINGH. UNIT
Rajasthan-301 713 Joginder Kumar resident: Vpo. Adiyana, Teh. 126 INF BN (TA) (JAK RIF) C/O 56 APO. RES the name of my daughter from Minakshi
ce record my daugh Madlauda, District Panipat, (Haryana) Pin Thakur to Meenakshi.
IDENT OF VILLAGE - NORA, Po- TEHSIL AND (1452)
ch is wrong but her 132113, have changed my Name from DISTRICT KATHUYA(J&K) DECLARE THAT IN 1, No.15787985X Hav Rakesh Kumar Verma resi
Yadav as per her BATERI DEVI to BHATERI Vide Affidavit Dated
dated 18.09.2024 08 January 2025 before at Notary Ferozepur.
MY SERVICE RECORD MY MOTHER NAME dent of Village- Bibi Tola, Post- Bairia, Tehsil
AND DATE OF BIRTH IS WRONGLY MEN Bairia, District- Balia, State Uttar Pradesh,
(4253) (Anand Ferozepur) TIONED AS BISHNO DEVI AND 01b6/1950 Pin-277201, have changed my Father name
ir Singh R/O VilL. Ihitherto known as SHIVANK SON OF SH. BUT HER CORRECT NAME IS. VISHNO DEVI from Sudrshn Prasad Verma to Sudrshn Verma
Khanpur, Distt. DINESH KUMAR, R/O VILLAGE PHULRA, AND DATE OF BIRTH IS 0509/1960 AS PER Vide affidavit No.IN-PB95486397805705X
e That My Given HER ADHAAR CARD AND PANCARD. dated 08 Jan 2025 before notary public
POST OFFICE NANGAL, TEH & DISTT
My Surname As Pathankot
PATHANKOT, PUNJAB, have changed my (4343 Nalenda)
name and shall hereafter be known as I, LAXMI Mother of No.16121543X L/HAV 1,TBharati Ben spouse of Thakor Sanjayji resi
Singh R/O Vpo. SHARMA SHIVANK. It is certified that I have dent of Village- Gothava, Post- Gothava,
rian, District
SAMBHAIMODGEKAR Sof Unit 38 AER, C/o
complied with other legal requirements in 56 APO presently residing at VILL MUCHAN Tehsil- Visnagar, District- Mahesana, State
hat My Given this connection. Gujarat, Pin-384315, have changed my name
Surname As DI, PO MUCHANDI, TEH BELGAUM, DIST
,Akul Mahajan Alias Divanshu Mahajan S/o BELGAUM, STATE KARNATAKA, PIN 590016 from T Bharati Ben to Thakor
Bharatiben
(4343 Guru) Sanjayji Vide affidavit
Late.Anil Mahajan, R/o Golden Avenue Saili have changed my name from LAXMI to No.IN
HAV Name Road Pathankot Have Changed My Name PB94378641071585X dated 03 Jan 2025
LAXMI MODAGEKAR vide affidavit dt.
gr Regt. Clo From Akul Mahajan Alias Divanshu Mahajan before notary public Pathankot
09.01.2025 before Notary Public Bathinda
coday camp to Divanshu Mahajan, For All Purpose. , Thakor Sanjayji resident of Village-
my Father , SHIVAI father of No.16121543X L/HAV Gothava,
Anand Ra0 Mukul S/o Hardip Singh, R/o Village Ranipur SAMBHAJI MODGEKAR Sof Unit 38 AER, C/O Post- Gothava, Tehsil- Visnagar, District
07.1951. Upperla, PO Shahpurkandi, Tehsil &District 56 APO presently residing at VILL MUCHAN Mahesana, State- Gujarat, Pin-384315, have
Pathankot (Punjab), Declare That My Name DI, PO MUCHANDI, TEH BELGAUM, changed my Mother name from THmd Ben to
ARank NK
is Mukul and Surname is Thakur, Now in DIST Thakor Samdiben Vide affidavit No.IN
it of 2 BELGAUM, STATE KARNATAKA, PIN 590016
Future IShall Use My Name Mukul Thakur, have changed my name from SHIVAJI PB94383853588700X dated 03 Jan 2025
2Residing
ra Tehsil Kindly Note
to
SHIVAJI MODAGEKAR vide affidavit dt. before notary public Pathankot
(A PTK)
sthan Pin , Kashming devi mother of No. 3998422X 09.01.2025 before Notary Public Bathinda , Thakor Sanjayji resident of
Village-
om Sanju Manohar Lal R/o Vil. Lalyar, P.O
NK Post- Gothava, Tehsil Visnagar, Gothava,
District
Dated 08 Teh. Bamson at Tauni Devi, Dist. Bagwara, IParbhu Singh S/o Onar Singh
(KG Chuchu) Mahesana, State- Gujarat, Pin-384315, have
epur. (H.P) declares that in Army Hamirpur is F/o JC changed my Father name from Javanji to
son, my name & DOB Wrongly
record of my 857363K Rank Sub (0CC) Manohar Singh Thakor Javanji Vide affidavit No.lN
Ashvin entered as Rathore Presently Residing at VPO Rajlota,
ding at Kashmiri Devi & 0204/1958. PB94383632705468)X dated 03 Jan 2025
strict correct name is Kashmiro Devi &Whereas
Dithave my
my correct
Teh Degana , Distt. Nagaur (Raj),
341503.have changed my Name from Pin before notary public Pathankot
DOB is 2003/1960. Please Note. (V
Rana) , Thakor Sanjayjl resident of vilage- Gothava,
Parbhu Singh To Prabhu Singh Vide affidavit Post- Gothava, Tehsil- Visnagar, District
Trom. Chandrawati is Mother of No dated 20.12.2024 before De
 Mob.: 77194-05026
email : sghps_ptk12@yahoo.in

SRI GURU HARKRISHAN PUBLIC SCHOOL

(AFFILIATED TO CBSE NEW-DELHI AFFILIATION No., - 1630161, SCHOOL CODE -20151)

Mission Road, Pathankot - 145 001.

Ref No-SGHPS/715 dated :2 1I/04/2025

Section Ofice

Correction Cell

C.B.S.E

Chandigarh

Sub:-Rectificationin Name of the candidate.

Sir

It is hereby submitted that a rectification in name of Mukul,who has passed class X under Roll No

13214146inthe year 2022, is solicited as per the plea ofthe parents in class X certificates issued by CBSE.

Parents have produced new birth certificate. The required rectification is as follows: -

Name of candidate as per class X record Required Name

Mukul Mukul Thakur

Keeping in view the future of the student you are requested to do the needful and oblige.

Please find enclosed the attested copies of the relevant documents required.

1. Attested Copy of class X D.M.C

2. Attested Copy of Birth certificate (new)

3. Attested Copy of Aadhar card

4. Gazzette notification

5. Notarized affidavait with correct name

6. Attested Copy of Admission and withdrawal Register

Kindly do the needful and oblige.

Thanking You

YQurs Sincerely
Bincipal

Road, Pathank145001
Prihedn
tode
630164
20151, Afl. N6.