Self Declaration Letter for Name Mismatch – Application for Name Mismatch Declaration

To,
The ______ (Department) Manager,
______ (Name)
______ (Address)

Date: __/__/____

Subject: Name Mismatch Declaration for __________ (purpose of name mismatch declaration)

Sir/Madam,

I ______ S/o D/o W/o residing at _____ hereby affirm that ____ (Name) as per document and _____ (Name) as per other document are of the same person.

I request you to kindly __________ (purpose of self declaration, eg: open an account/update record/ issue Mobile SIM) in the name of ________ (Correct Name as per) as per _____ (document where spelt differently).

I will be solely responsible for any consequences arising out of any difference due to the above requested change.

Thanking You,

Signature: _____
Name: ______
Contact: _____