A F F I D A V I T

(FOR DATE OF BIRTH)

I, Sri Dipak Chandra Ghosh, alias Dipak Ghosh, son of Santosh
Chandra Ghosh, aged about 67 years, by Faith Hindu, by Nationality
Indian, by Profession usiness, presently residing at!" #$%&"#,
Purbapally, P'(' Sodepur, P' S' )hardah, Distri*t %+ Parganas
,North-, Pin 7..//., do hereby sole0nly affir0 on oath and de*lare
as follo1s!"
Contd22%

"%"
/' 3hat I a0 a bonafide *iti4en of India and ha5e been residing at the
abo5e 0entioned 6ddress'
%' 3hat 0y parents infor0 0e that I 1as born on /
st
7anuary, /8+7
,./$./$/8+7-, at 0y parental ho0e'
9' 3hat in 0y 5oter Identity *ard bearing no :$%.$/9&$&7..9%, issued
by the #le*tion Co00ission of India sho1s, on ./$./$/88&, 0y age
1as +;'
+' 3hat Sri Dipak Chandra Ghosh, and Dipak Ghosh is one and sa0e
identi*al person 1hi*h refer to 0e'
3he state0ents 0ade in the abo5e paragraphs of this affida5it are true to
the best of 0y kno1ledge and belief'
""""""""""""""""""""""""""""""""""
,D # ( P N # N 3-
Sole0nly affir0 before 0e and Signed before 0e and
by the Deponent, 1ho is identified identified by 0e
by Sri Sankarnath Chakraborty, 6d5o*ate
on this day' 6d5o*ate

7udi*ial <agistrate, First *lass