Government of Maharashtra: Sana Malik Ahmad Momin Sana Saheem Sukte

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GOVERNMENT OF MAHARASHTRA

DIRECTORATE OF GOVERNMENT PRINTING, STATIONERY AND PUBLICATION FORM FOR


CHANGE OF NAME NOTICE
N.B-
(Instructions may be followed carefully before filling up this form, only one word should be
written in each space printed below. Please fill up this form in English version and in BLOCK
LETTERS ONLY) It is hereby notified that the undersigned has changed his/her name from

OLD NAME SANA MALIK AHMAD MOMIN


NEW NAME SANA SAHEEM SUKTE

NOTE: Government accepts no responsibility as to the authenticity of the contents of the notice.
Since they are based entirely on the application of the concerned persons without verification of
documents.

Signature of the Guardian


(In case Minor) Signature in old name/Thumb impression
With Name and Date
(Write down the name of the person in the above space who
Has signed above)
To,
The Director,
Government Printing. Stationery and publication, Maharashtra, Mumbai 400004.
Kindly publish the above notice in the next issue of the Maharashtra government Gazette, Part II

Reason for change of Name: DUE TO MARRIAGE

Signature in New Name/Thumb Impression with Name and date.

For Corresponding Address


New Name : SANA SAHEED SUKTE
Address : TIPU SULTAN CHOWK DARGAH DIWANSHAH AZMI NAGAR BHIWANDI
Pin code : 421302
Tel.No :
Mobile No. : 9921623805

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