AFFIDAVIT

By this deed I, the undersigned AAYYUSH RAJALINGA (new name) previously called as
REUBEN SELVARAJ (old name) S/O P.R. Selvaraj, is practicing as Doctor in
Naturopathy and Yoga Medical Science as Duty Doctor at I- AIM Healthcare Center
Bangalore-560064.
I am residing at #213 1ST floor 5th cross, Defence Layout, Vidyaranyapura, Bangalore-
560097.
Solemnly affirm and declare as under:
1. That my name has been recorded as REUBEN SELVARAJ in all the educational
certificates/other certificates.
2. That I confirm my date of birth is 09/04/1988 (9th April 1988) and the same is in all my
certificates and other relevant documents.
3. That for and on behalf of myself I wholly renounce/ relinquish and abandon the use
of my former name/ surname of REUBEN SELVARAJ and in place thereof, I do hereby
assume from the date the name/ surname AAYYUSH RAJALINGA so that I may
hereafter be called, known and distinguished not by my former name/surname, but
assumed name/surname of AAYYUSH RAJALINGA.
4. That for the purpose of evidencing such my determination declare that I shall at times
hereafter in all records, deeds and writings and in all proceedings, dealings and
transactions, private as well as upon all occasions whatsoever use and sign the name
AAYYUSH RAJALINGA as my name/surname in place and in substitution of my former
name /surname
5. That I expressly authorize and request all persons in general and relatives and friends
in particular, at all times hereafter to designate and address me, by such assumed
name/surname of AAYYUSH RAJALINGA.
6. In witness whereof I have hereunto adopted my name/surname as AAYYUSH
RAJALINGA and affix my signature and seal, if any, this 12th day of September 2017

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

Assumed present name Signed sealed and delivered by the

above name
Signed by AAYYUSH RAJALINGA Former name REUBEN SELVARAJ
Date :

In the presence of:

Witness no. 1
Signature ……………………… Full Name……………………..
Address ……………………………….

Witness no. 2
Signature ……………………… Full Name……………………..
Address ……………………………….