(Former Name) (Designation of The Post Held at The Time by The Govt. Servant)
(Former Name) (Designation of The Post Held at The Time by The Govt. Servant)
(Former Name) (Designation of The Post Held at The Time by The Govt. Servant)
…………………………………………………………………………………………………………………………………………………………………………………………..
(Place where employed in the Ministry/ Department of the Govt. of India)
…….……………………………………………………………………………………………………………………………………………….……do hereby:-
1. Wholly renounce, relinquish and abandon the use of my former name of ………………………………………………………….
and in place thereof do assume from the date thereof the name of …………………………..………………………… and so
that I may hereafter be called, known and distinguished not by my former name of
…………………………………………………………………… but by my assumed name of
……………………………………………………………………………
2. For the purpose of evidencing such my determination, declare that I shall at all times hereafter in all records,
deeds and writings and in all proceedings, dealings and transactions private as well as public and upon all
occasions whatsoever use and sign the name of …………………………………………………………………… as my name in
place of and in substitution for my former name of ……………………………………………………………………
3. Expressly authorities and request all persons at all times hereafter to designate and address me by such
assumed name of ……………………………………………………………………
4. IN WITNESS WHEREOF I have hereunto subscribed my former and adopted name of
…………………………………………… and …………………………………….. affixed my seal this ………. day of
……………………………………………
Old Signature……………………………………………..
New Signature…………………………………………….
Signed and delivered by the above
Name ……………………………………………………………
Formerly ………………………………………….……………In presence of:-
Witness No. 1.
Signature ………………………….……………………. (Name) ………………………………………….…….. Designation…………….…..………………….
Official Address ………………………………………………………………………………………………………………………………………………………………….
(With Rubber Stamp)
Witness No. 2.
Signature ……………………………….……… (Name) …………………………………………….. Designation………………………………….
Official Address ………………………………………………………………………………………………………………………………………..………..
(With Rubber Stamp)
DEED CHANGING NAME/ SURNAME
BY THIS DEED I the undersigned Monu Kumar Sharma Lately called Monu Kumar Sharma employed as Inspector at
(Former name) (Designation of the post held at the time by the Govt. servant)
Central Board of Indirect Taxes and Customs, Central Revenue Building, 5A, main Road, Dist- Ranchi, State- Jharkhand,
Old Signature……………………………………………..
New Signature…………………………………………….
Signed and delivered by the above
Name ……………………………………………………………
Formerly Monu Kumar Sharma In presence of :-
Witness No. 1.
Signature ………………………….……………………. (Name) ………………………………………….…….. Designation…………….…..………………….
Official Address ………………………………………………………………………………………………………………………………………………………………….
(With Rubber Stamp)
Witness No. 2.
Signature ……………………………….……… (Name) …………………………………………….. Designation………………………………….
Official Address ………………………………………………………………………………………………………………………………………..………..
(With Rubber Stamp)