Submitted by: Amolbsurve
Respected Sir / Madam,
With due respect and honor it is to state that I the undersigned Mr. Amol Baliram Surve,
son of Late. Baliram Gujaba Surve, request you to kindly correct the name of my father’s father & Mother Name which is not properly written.
Also mention the name of my mother’s name as a wife of my father in the death certificate which is not written.
These specific updations are as follows & also mentioned in attached copy with this application which is originally provided by you.
Other than these corrections all information is correct.
NAME OF DECEASED IS CORRECTLY WRITTEN IN CERTIFICATE SO DON’T EDIT THIS NAME.
NAME OF DECEASED: – BALIRAM GUJABA SURVE.
CORRECTION`S ARE AS BELOW.
NAME OF WIFE: – GEETA BALIRAM SURVE.
NAME OF MOTHER: – BHAGIRATI GUJABA SURVE.
NAME OF FATHER: – GUJABA SHRIPATRAO SURVE.
REGISTRATION NO. :- D[protected]
ISSUE DATE :[protected]