GOVERMENT OF MAHARASHTRA DIRECTORATE OF GOVERNMENT PRINTING STATIONERY AND PUBLICATION FORM FOR CHANGE OF NAME NOTICE ne {instructions may be folwed caretly before fling up this frm. Only one wors shoul be wien in each space printed below. Please fill up this form in English version and in BLOCK LETTERS only) itis horeby notified thatthe undersigned has changed his/her name from [oid Name | ss Faerslnusbande Name Suinaiie I ia se SHEE EEE See EEE J Note = Goverment accepts no responsibilty 2s tothe authenticity of the contents ofthe notice. Since they are based entity onthe application ofthe concerned persons without veiication of documents. Signature ofthe Guardian oem Signature in Old name! Thumb Impression with Name and Date (In case of minor ) (Wte down the name of the person in the above space whe has signed above) To THE DIRECTOR, ‘Government Printing, Stationery and Publications, Maharashtra, Mumbai 400 004, Kindly publish the above Notice in the next issue of the Maharastra Government Gazette, Pert I Reason for change of Name Signature in New Name/Thumb Impression with Name and Date, FOR CORRESPONDING ADDRESS: New Name: Adress Pincose: Tel No: ‘Mobile No: