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Notice for advertisement by individual in the Gazette of India Part-1V regarding 1
Change of Name, addition or deletion of surname, etc.

The following documents are required for publication of advertisement in the

Gazette of India Part IV.

(i) An Undertaking duly signed by the applicant

(ii) Original Newspaper
(iii) Prescribed proforma in duplicate, duly typed with signature of applicant
and two witnesses.
(iv)C.D. containing the print matter without witness portion in MS Word and
type old name in place of signatUre.
(v) Two self attested passport size• photographs and photocopy of TD proof
(self attested).
(vi) A certificate duly signed by the applicant declaring therein that the
contents of hard copy and soft copy are similar.
(vii) Request letter along with the requisite fee.

The peipon attaining the age of 18 yrs. and above who wishes to get his/her
change of name published in the Gazette of India Part-IV. has to comply with the
following formalities prior to publication of Such advertisement.
Change of name should be advertised in one of the daily local leading newspaper
stating therein Father's / Husband's name along with residential address and
forward it in original to this Department.

2. An Undertaking duly signed by the applicant showing therein his/her old and
new name along with full details of father's I. husband's name with
residential address declaring that the facts stated therein are true &
correct to the: best of his/her knowledge and belief. In case of
individuals working with Central Government, they may submit Deed for change
of name in accordance witlfthe Ministry of Home Affairs 0. M. No. 190016 / 11
87-Estt. dated 12/03/1987. Specimen deed is attached. In case of Indians living
abroad, he / she will submit deed duly attested by the respective Indian Embassy /
Indian High Commission, in original to this Department.

3, Printing matter as prescribed in the attached specimen duly complete in all

respectS by typing the same on a separate plain paper and signed by the individual
in his / her old name, with two witnesses in duplicate should be submitted along
with Soft Copy (CD MS Word). The Proforma must be computer typed.
4. The applicant is required .to submit two self attested passport size photographs
along with application with all the reqUisite documents containing two passport
size photographs and copy of photo ID proof, both duly self attested..

'T 0
prirtti% charges for publication of ch911
1 ..of Larne is Rs. 1100/-only w.e.f.
01.04,2016 to 31.03.2017 .The amount will have to be submitted thorough NTRP (Non Tax Reciept
Portal i.e www.hharatkash.gov.in from 01/1
0/2018 onwards vide Department Order
No.Cash/NTRP/2018-19 Dated 04/1
0/18 in pursuance of Principal Accounts Office, 11/1/o Housing &
Urban Affairs' O.M.
No,G-20018/Pr.Ao/UD/A/Cs/NTRP/2018-19/1489-1504 Dated 01-10-2018.
ibr Indian living abroad • is Rs.3500/- Daly w.e.f. 01
. 4.2016 to 31.3.2017. The
0.
applicant is requested to download his/her gazette from the website
www.eggzettealic,in in the following manner as the physical printing and sale of
hard copies of the Gazette by the Government has been ceased completely from
01.10.2015 vide Gazette of India Issue no. 602, Extra Ordinary Part 11 Section 3
Sub Section (1) dated 30.9.2015, be switched to e- publishing w.e,f 0I' October,
20'15.

STEPS:- TO SEARCH GAZETTE

STEPI :- SEARCH GAZETTE

STEP2:- SEARCH CATEGORY-WEEKLY GAZETTE

STEPS:-IN SELECT PART AND SECTION- PARTLY

STEP4:- IN 1ST CLALENDER (DATES OF SATURDAY) TO I1ND

CA LENDER (DATES OF SATURDAY)

STEPS:- DOWNLOAD THE REQUISITE PDF FILE.

STEP6:-USE CONTOL KEY-I-F KEY TO FIND YOUR NAME (OLD/NEW)

STEM-DOWN LOAD THE WHOLE GAZETTE TO MAKE YOUR OWN

COPY, THIS FURTHER NEEDS NO CERTIFICATION FROM THE
DEPARTMENT

N,13.: The Publication. Department will not be responsible for any tampering
in the downloaded copies of e-publishing Gazette from the website
6. All the aforesaid documents, printing charges together
with forwarding letter and
Photo ID Proof addressed to The Controller of Publications, Department of
Publication, Civil Lines, Delhi-I 10054 should either be submitted personally or
be sent by post to this Department. The documents must not be older than one
year.

7. The documents once submitted in this Department will not be returned in any
circumstances, neither original nor Xerox copy.

8. The public dealing hour for this purpose in this Department are 10.00 AM to 1.00
PM and 2.00 PM-to 4.00 PM on all working days,

P.7 0
9 [A] If the individual applies to adopt the name/ surname of any other religion without changing his/
her existing religion than he/ she must submit An Undertaking duly signed by the applicant showing
therein his/ her full particulars with residential address stating therein that old and new name along
with full details of father's/ husband's name with residential address declaring that "He/She confirms
that he/she is not changing his/her religion" The cost of such type of advertisement will be Rs.1100/+Rs.
250/----Rs.1350/- [Till Date.]

[B] In case, the individual applies change of religion, he/ she must declare the Same in the leading
newspaper as well as in the UNDERTAKING.

10 Every application should be supported by self attested Photo ID proof of the applicant. Application
either submitted personally or sent by Post/ Courier only will be entertained. No other channel is
permissible viz Agents, Advocates, etc.

11. A certificate duly signed by applicant declaring therein that the contents of hard copy and soft copy
are similar with the undertaking that the applicant will be responsible for any mismatch or loss in transit.
12.After the application is received completed in all respect, the request will be sent for notification to
the respective Government of India Press.
13.
This department will not be responsible for any delay in printing on the part of concerned Press.
14.
The Controller of Publications, being the publisher of the Gazette Of India, reserves the right to
reject any request found incomplete /vague/unlawful/misleading printing material for publication of
the matter.

Controller of Publications.

2.7. '0
SPECIMEN FOR CHANGE OF NAME FOR
MAJOR

I hitherto known as (OLD NAME) Son/ Daughter/Wife of

(Father/Husband's Name)employed as (Post of the Applicant) in the
(Office /Company's Name) residing at (residential address) have
changed my name and shall hereafter be known as (New Name).

It is certified that I have complied with other legal requirements in

this connection.

(Type here your Old Name)

Signature (in existing Old Name)

Witness No.1:-
Full Name Signature
Address
Mobile /Phone No.

Witness No.2:-
Full Name Signature
Address
Mobile /Phone No.

P.T.O
\Ai t7 SPECIni COPieZ

CHANGE OF NAME FOR MAJOR

I hitherto known as (OLD NAME) Son/ Daughter/Wife of
(Father/Husband's Name)employed as (Post of the Applicant) in
the (Office /Company's Name) residing at (residential address)
have changed my name and shall hereafter be known as (New
Name).
It is certified that I have complied with other legal requirements in
this connection.

(Type here your Old Name)

Signature (in existing Old Name)

Witness No.1:-
Full Name Signature
Address
Mobile /Phone No.

Witness No.2:-
Full Name Signature
Address
Mobile /Phone No.

I hitherto known as Ayush s/o Sunil Bhatnagar I hitherto known as Ayush s/o Sunil Bhatnagar
employed as Senior Engineer in HCL employed as Senior Engineer in HCL
company,Sector-60,Noida residing at 17, company,Sector-60,Noida residing at 17,
ashok vatika, lajpat nagar, delhi have change ashok vatika, lajpat nagar, delhi have change
my name and shall hereafter be known as my name and shall hereafter be known as
Ayush Bhatnagar. Ayush Bhatnagar.

It is certified that I have complied with other It is certified that I have complied with other
legal requirements in this connection. legal requirements in this connection.

(Type here your Old Name) (Type here your Old Name)
Signature (in existing Old Name) Signature (in existing Old Name)
Witness 1 Witness 1
Name Ashok Sharma Signature Name Ashok Sharma Signature
Address 171, Sector -14,Sonipat, Haryana, Address 171, Sector -14,Sonipat, Haryana,
Mob.7777777771 Mob.7777777771
Witness 2 Witness 2
Name Rajesh Sharma Signature Name Rajesh Sharma Signature
Address 171, Sector -14,Sonipat, Haryana, Address 171, Sector -14,Sonipat, Haryana,
Mob.8888888881 Mob.8888888881

(i)Specimen should not be hand written.

(ii)Type old Name and Sign Format by old Name Only.

(iii)New name must be One Only.

(iv)New Name should not contain S/o, W/o ex. Ramesh S/o Rambir,, Prerna W/o Rajat etc.
Give your fullname.

(v)Don't mention Age in above format.

CD MATTER
COMPACT DISC-ONLY BELOW MATTER SHOULD BE TYPED IN
MS Word and be put in CD with old name only.

I Hitherto Known as old Name S/o,

/daughter/wife of employed
as..........in company/organization
residing at have change my
name and shall hereafter be known as
new name.
It is certified that I have complied with
other requirements in this
connection.

OLD NAME(Instead of Signature)

CD should not contain :-

i)No scanned matter.(No .pdf,jpeg, jpg etc.)(Only in
doc/docx format only).
ii) No Signature
iii) No Witness Details
iv) No Application, No Photographs,No Affidavit
Details, No ID Details etc.