A Government employee wishing to adopt a new name or to effect any modification in his / her existing name may do so, formally by a deed changing his / her name. in a prominent local newspaper as well as in the Gazette of India at the Government employee's own expense.
i
:
BY THIS DEED the undersigned
(Former name)
L
(Designation or tile
post held ul the time by the (MK servant).
(Place when: employed in the Ministry/Department or the Govt. or India)
Wholly renounce, relinquish and abandon on the um of my thriller name or
and in place thereof dO.assutne from the date there of the name or rennet name orand so tbut t may hereafter be called, lutown and 'distinguished not by my
of 2.
but by my assumed name Vor the purpose of evidencing sod) my determination, &dare that 1 shall ut ull times
hereafter in all records, deeds and writings und
IS ' sign the name my name in place or anti in substitution For my ihrirair
13xpressly authorities and request till persons at all tithes hereafter to designate and address by such assumed name of
In witness whereof
I have
Signed and delivered by the above named
formerly
Signature.
Name Designatiot Orkin, Address
(With Rubber stamp) ltaggatlgs- 2,
Signature
Name Designation Official Address
—9./ith Rubber stump)